Organization
O FRED MOORE III MD PC
Active
Other names
Drs James A Caylor & O Fred Moore III
Organization subpart
No
Provider details
NPI number
Authorized official
OLYN FRED MOORE III MD (PRESIDENT OF CORPORATION)
(731) 285-5244
Entity
Organization
Contact information
Practice address
503 TICKLE STREET, DYERSBURG, TN 38024
(731) 285-5244
(731) 285-5244
Mailing address
503 TICKLE STREET, DYERSBURG, TN 38024
(731) 285-5244
(731) 285-8970
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3384206
—
TN
Enumeration date
04/26/2007
Last updated
08/22/2020
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