Provider Demographics
NPI:1265577084
Name:MOULEDOUX, ANDRE JEAN JR (MD)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:JEAN
Last Name:MOULEDOUX
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:ONE VANTAGE WAY, SUITE B-240
Mailing Address - Street 2:MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1562
Mailing Address - Country:US
Mailing Address - Phone:410-328-8025
Mailing Address - Fax:410-328-8028
Practice Address - Street 1:400 NORTH HIGHLAND AVE
Practice Address - Street 2:MIDDLE TENNESSEE MEDICAL CENTER
Practice Address - City:MURFRESSBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:410-328-8025
Practice Address - Fax:410-328-8028
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2010-05-05
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Provider Licenses
StateLicense IDTaxonomies
TN46042207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine