Allan J Moede, M.D.
Individual provider Active NPI Orthopaedic Surgery Physician · MC Kenzie, TN
NPI 1871582007 · NPPES record last updated Jan 11, 2017
Key facts
- NPI
- 1871582007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- MD55243 (TN)
- Practice address
- 205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649 - Phone
- (731) 352-7907
- Fax
- (731) 352-4459
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD55243 | TN | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKenzie Medical Center PC | Orthopaedic Surgery | Current | Accepting new patients |
| McKenzie Medical Center | Past | Accepting new patients | |
| McKenzie Medical Center | Past | Accepting new patients | |
| McKenzie Medical Center, PC | Past | Accepting new patients |
Locations
205C Hospital Dr
Mc Kenzie, TN 38201
Phone (731) 352-0820
205 Hospital Dr
Ste A
Mc Kenzie, TN 38201
Phone 7313527907 ext. 429
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD55243 | TN | Yes |
Addresses
Primary practice location
205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Mailing address
205 Hospital Dr
Suite a
MC Kenzie, TN 38201-1649
Phone (731) 352-7907
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3380640 | Other | TN | GROUP MEDICAID |
| 3380640 | Other | TN | GROUP MEDICARE |
Other providers in MC Kenzie, TN
- Brianna Douglas McKinney
- Med-Trans Corporation
- Heather Anne Melton
- Bryan Hale Merrick
- William Boothe Merrick
- James O Morgan
- Christie Mort
- John E Motheral
- Paul Thomas Motheral
- Nichelle Lee Napier
All providers in MC Kenzie, TN · Orthopaedic Surgery Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.