Moore, George Richard
Moore, George Richard is an individual health care provider with primary practice located at 1265 Hwy 54 W , Fayetteville GA 30214. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Moore, George Richard can be contacted via phone (770) 997-5714.Contact Information
Primary practice address
1265 Hwy 54 W
Fayetteville GA 30214
Phone: (770) 997-5714
Fax: (770) 997-2810
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 012525 | Georgia |
Profile Details
| NPI number | 1235153586 |
|---|---|
| LBN Legal business name | Moore, George Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Dec 24th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235153586 | NPPES |
| Georgia | MEDICAID | 00393225A |
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