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Individual

ROBERT S MOORE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11657 CHAPMAN HWY, SEYMOUR, TN 37865-5047
(865) 577-4836
(865) 573-8831
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
(865) 584-1363

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD24149
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
37066302
MEDICARE LEGACY GROUP
TN
01
P00436763
RR MEDICARE PIN
TN
Enumeration date
09/01/2006
Last updated
05/09/2008
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