Guy W. Moorman, Jr. DDS. PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN007456 Issued in GA

Legal business name

GUY W. MOORMAN, JR. DDS. PC

Practice address

1150 Ward Street Ext W
Douglas, GA 31533-1900

Phone

(912) 384-7400

NPI assigned

Dec 11, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tammy Lynn Smith

Title

Office Manager

Phone

(912) 384-7400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1013382316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 WARD STREET EXT W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315331900",
            "telephone_number": "912-384-7400",
            "fax_number": "912-384-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 WARD STREET EXT W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315331900",
            "telephone_number": "912-384-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUY W. MOORMAN, JR. DDS. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-384-7400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN007456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578698650",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Princess Graves
• Karen Michelle Green, PA
• Gregory M Thackston, DMD,Magd,LLC
• Kiplyn Griffin, SLP
• Kristi Rebecca Gross, CST, CSFA
• Jessical Hall, M.ED CCC-SLP
• Julie Johnson Hall, FNP-C
• Hanger Prosthetics & Orthotics, Inc. (Hanger Clinic)
• Tara Leigh Harden-Lee, BCBA
• Hark Pharmaceutical, LLC (Malcolms Discount Pharmacy)

• Dental Clinic/Center in Douglas, GA
• Providers in Douglas, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.