Provider Demographics
NPI:1972779395
Name:MOORMAN, RHONDA M (MD)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:M
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2437
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31534-2437
Mailing Address - Country:US
Mailing Address - Phone:912-393-4723
Mailing Address - Fax:888-832-5460
Practice Address - Street 1:2348 GA HIGHWAY 32 E
Practice Address - Street 2:
Practice Address - City:WRAY
Practice Address - State:GA
Practice Address - Zip Code:31798-3503
Practice Address - Country:US
Practice Address - Phone:912-393-4723
Practice Address - Fax:888-832-5460
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060127207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine