Individual
JODI-ANN CAMILLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
9 MEDICAL DR NE STE E, CARTERSVILLE, GA 30121-8003
(470) 227-1600
(470) 227-1606
Mailing address
9 MEDICAL DR NE STE E, CARTERSVILLE, GA 30121-8003
(470) 227-1600
(470) 227-1606
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
005365
GA
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
005365
GA
Other
Enumeration date
08/11/2008
Last updated
05/27/2021
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