Provider Demographics
NPI:1962518316
Name:MOORE, HAROLD EARL JR (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:EARL
Last Name:MOORE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5461 HILLANDALE DRIVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4842
Mailing Address - Country:US
Mailing Address - Phone:404-778-8600
Mailing Address - Fax:770-322-7983
Practice Address - Street 1:2764 CANDLER RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-1410
Practice Address - Country:US
Practice Address - Phone:404-778-8600
Practice Address - Fax:404-778-8632
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2016-03-17
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Provider Licenses
StateLicense IDTaxonomies
GA029216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine