Provider Demographics
NPI:1447232103
Name:MOORE-RUFFIN, JADA EA (MD)
Entity Type:Individual
Prefix:
First Name:JADA
Middle Name:EA
Last Name:MOORE-RUFFIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5900 HILLANDALE DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3802
Mailing Address - Country:US
Mailing Address - Phone:770-322-9660
Mailing Address - Fax:770-322-1981
Practice Address - Street 1:5900 HILLANDALE DR
Practice Address - Street 2:SUITE 215
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3802
Practice Address - Country:US
Practice Address - Phone:770-322-9660
Practice Address - Fax:770-322-1981
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2015-05-18
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Provider Licenses
StateLicense IDTaxonomies
OH35073421207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine