Individual
GREGG PHILIP MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15242 GREENFIELD DR, ATHENS, AL 35613-2897
(256) 233-2914
(256) 230-9005
Mailing address
15242 GREENFIELD DR, ATHENS, AL 35613-2897
(256) 233-2914
(256) 230-9005
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00027450
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009937807
—
AL
01
—
510-03990
BCBS OF AL
AL
Enumeration date
06/13/2006
Last updated
01/31/2019
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