Provider Demographics
NPI:1922371707
Name:MOYE, THOMAS CARBERT
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CARBERT
Last Name:MOYE
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 1:98 E OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-1529
Mailing Address - Country:US
Mailing Address - Phone:229-336-2255
Mailing Address - Fax:229-336-2257
Practice Address - Street 1:98 E OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-1529
Practice Address - Country:US
Practice Address - Phone:229-336-2255
Practice Address - Fax:229-336-2257
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist