Larry R Moorman M D, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

014938 Issued in GA

Legal business name

LARRY R MOORMAN M D, PC

Practice address

1803 Old Ocilla Rd
Tifton, GA 31794-1617

Phone

(229) 386-2181

Fax

(229) 386-2193

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Debra H Moorman

Title

Office Manager

Phone

(229) 386-2181

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Tifton Ophthalmology Doing business as

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1225193329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941617",
            "telephone_number": "229-386-2181",
            "fax_number": "229-386-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941617",
            "telephone_number": "229-386-2181",
            "fax_number": "229-386-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY R MOORMAN M D, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "MOORMAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-386-2181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "014938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0774710001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC4435",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GRP2612",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tifton Ophthalmology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Kreschollek, CRNA
• Michael Kuo
• Lala Land Anesthesia, LLC
• Lacey Jackson Landon, AA
• Ulla Lappi-Norqdvist, PT
• Kamran Lateef, MD
• Anna Kennedy Lavender, FNP-BC
• Lori White Laycock
• Linh Le, RPH
• Alta M Lebeck, L.D.O.

• Ophthalmology Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.