Individual
JAMES A. MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 MOUNTAIN DR, SUITE # 6, DESTIN, FL 32541-7327
(850) 837-8831
Mailing address
PO BOX 368, DESTIN, FL 32540-0368
(850) 837-8831
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101033738
VA
208600000X
Surgery Physician
Primary
ME0052108
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048081900
—
FL
Enumeration date
07/22/2005
Last updated
10/07/2010
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