Provider Demographics
NPI:1518118710
Name:MOYERS, CLAUDE E
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:E
Last Name:MOYERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 SANITA VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:BEAN STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37708-4620
Mailing Address - Country:US
Mailing Address - Phone:423-312-9671
Mailing Address - Fax:865-993-8938
Practice Address - Street 1:169 SANITA VILLAGE RD
Practice Address - Street 2:
Practice Address - City:BEAN STATION
Practice Address - State:TN
Practice Address - Zip Code:37708-4620
Practice Address - Country:US
Practice Address - Phone:423-312-9671
Practice Address - Fax:865-993-8938
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver