Individual
DR. RICHARD A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, M.D.
Contact information
Practice address
979 E 3RD ST, STE 300, CHATTANOOGA, TN 37403-2136
(423) 267-0466
(423) 778-8168
Mailing address
979 E 3RD ST, STE 300, CHATTANOOGA, TN 37403-2136
(423) 267-0466
(423) 778-8168
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD36974
TN
208C00000X
Colon & Rectal Surgery Physician
Primary
MD36974
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00968899A
—
GA
05
—
009915145
—
AL
01
—
1990242001
CIGNA
—
01
—
280001172
RR MEDICARE
—
01
—
4046885
BCBS OF TN
—
01
—
62165877478
JDH
—
05
—
Q002576
—
TN
Enumeration date
09/08/2005
Last updated
02/18/2019
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