Individual
KIMIKO JEAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 NEWNAN CROSSING BLVD E STE 200, NEWNAN, GA 30265-2409
(770) 400-7700
Mailing address
9200 SHELBYVILLE RD STE 531, LOUISVILLE, KY 40222-5132
(502) 792-0236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
65954
TN
207Q00000X
Family Medicine Physician
Primary
98646
GA
Other
Enumeration date
04/01/2019
Last updated
02/25/2025
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