Provider Demographics
NPI:1841324670
Name:THE MOORE CENTER FOR PLASTIC SURGERY, P.C.
Entity type:Organization
Organization Name:THE MOORE CENTER FOR PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-613-6650
Mailing Address - Street 1:489 N MILLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-3807
Mailing Address - Country:US
Mailing Address - Phone:706-613-6650
Mailing Address - Fax:706-613-6868
Practice Address - Street 1:489 N MILLEDGE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-3807
Practice Address - Country:US
Practice Address - Phone:706-613-6650
Practice Address - Fax:706-613-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty