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Individual

PATRICIA MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
190 HANDLEY RD, TYRONE, GA 30290-2178
(770) 997-5714
(770) 997-2810
Mailing address
190 HANDLEY RD STE A, TYRONE, GA 30290-2178
(770) 997-5714
(770) 997-2810

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
GA056875
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
741370127F
GA
01
7966709
AETNA
GA
Enumeration date
07/27/2006
Last updated
09/02/2020
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