Provider Demographics
NPI:1013085679
Name:MOORE JARMON, MARQUISHA DENISE (MD)
Entity Type:Individual
Prefix:
First Name:MARQUISHA
Middle Name:DENISE
Last Name:MOORE JARMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARQUISHA
Other - Middle Name:DENISE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:430 EMERY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4595
Mailing Address - Country:US
Mailing Address - Phone:205-855-0357
Mailing Address - Fax:205-941-7061
Practice Address - Street 1:430 EMERY DR STE 200
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4595
Practice Address - Country:US
Practice Address - Phone:205-855-0357
Practice Address - Fax:205-941-7061
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28059208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics