Provider Demographics
NPI:1164886107
Name:MOORE, LEIAH E (DO)
Entity Type:Individual
Prefix:
First Name:LEIAH
Middle Name:E
Last Name:MOORE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1575
Mailing Address - Country:US
Mailing Address - Phone:615-342-5900
Mailing Address - Fax:615-342-5912
Practice Address - Street 1:2400 PATTERSON ST STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1575
Practice Address - Country:US
Practice Address - Phone:615-342-5900
Practice Address - Fax:615-342-5912
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN3677207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine