CHARLES B MOOMEY JR MD


Address: 631 Professional Drive, Suite 300, Lawrenceville, GA 30046-3371
Phone: 7709629977

CHARLES B MOOMEY JR MD (NPI# 1902003841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902003841
Entity Type Organization
Organization Name CHARLES B MOOMEY JR MD
Practice Address 631 Professional Drive
Suite 300
Lawrenceville
GA 30046-3371
Practice Telephone 7709629977
Practice Fax Number 7703399804
Mailing Telephone 7709629977
Mailing Fax Number 7703399804
Enumeration Date 2007-07-02
Last Update Date 2010-09-01
Authorized Official Name CHARLES BRUCE MOOMEY JR. (OWNER)
Authorized Official Telephone 7709629977
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0129X Surgery
Specialization: Vascular Surgery
049923 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
GA 00899951A 05

Office Location

Street Address 631 PROFESSIONAL DRIVE
SUITE 300
City LAWRENCEVILLE
State GA
Zip Code 30046-3371

Providers in the same location

NPI Name Taxonomy Address Enumeration
1487651386 Wallace Ford Martin Surgery 631 Professional Drive, Suite 300, Lawrenceville, GA 30046-3371 2005-07-07
1003041104 Barbara O'callaghan Registered Nurse 631 Professional Drive, 450, Lawrenceville, GA 30046-7651 2009-05-19
1861627028 Theresa Lynn Catlin Registered Nurse 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 2009-05-18
1639226178 John A. Chandler Physician Assistant 631 Professional Drive, Suite 200, Lawrenceville, GA 30046-3367 2007-01-05
1710049036 Gwinnett Consultants In Cardiology Specialist 631 Professional Drive, Ste 360, Lawrenceville, GA 30046-0000 2006-12-14
1508926759 Suburban Hematology Oncology Associates, PC Internal Medicine 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 2006-12-11
1659460244 Christopher T Hagenstad Internal Medicine 631 Professional Drive, Ste 210, Lawrenceville, GA 30046 2006-10-12
1821187436 Anthony M Landis Internal Medicine 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 2006-10-12
1073602751 Alexander Saker Jr. Internal Medicine 631 Professional Drive, Suite 450, Lawrenceville, GA 30046 2006-10-12
1114969052 Satvir Singh Internal Medicine 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 2006-06-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063023174 Alpha & Omega Hearing Centers Hearing Instrument Specialist Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 2020-08-12
1285259846 Mesun Health Services, Inc Clinical Nurse Specialist 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 2020-06-10
1215550264 Mesun Health Services, Inc Skilled Nursing Facility 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 2020-05-26
1306499785 Bryan Acosta Chiropractor 471 Scenic Hwy South, Lawrenceville, GA 30046 2019-07-24
1205308616 Belle Lumiere Cosmetics LLC Dermatology 753 Old Norcross Road, Lawrenceville, GA 30046 2018-12-24
1548730179 Alexis Nicole Robinson Nurse Anesthetist, Certified Registered 1000 Medical Center Boulevard, Lawrenceville, GA 30046 2018-11-27
1679060388 Christopher Puckett Student in an Organized Health Care Education/Training Program 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 2018-04-18
1457851255 Advanced Urology Institute of Georgia Urology 501 Crown Point Way, Lawrenceville, GA 30046 2018-02-19
1013447044 Pharmacy Investments of Lawrenceville, LLC Pharmacy 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 2017-06-13
1225577000 Priority Housecalls LLC Clinic/Center 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 2017-02-14
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689012205 Daniel Joseph Badia Surgery 601 Professional Dr Ste A220, Lawrenceville, GA 30046-7698 2013-06-05
1477556371 Stephen K Ball Surgery 631 Professional Dr Ste 200, Lawrenceville, GA 30046-3371 2005-05-24
1780070235 Sesank Sai Mikkilineni Surgery 601 Professional Dr Ste A220, Lawrenceville, GA 30046-7698 2015-04-11
1629039052 Sudhindra K Anegundi Surgery 631 Professional Drive, Suite 300, Lawrenceville, GA 30046-3371 2006-03-28
1932107349 James Kevin Elsey Surgery 631 Professional Drive, Suite 300, Lawrenceville, GA 30046-3371 2005-07-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1285241265 Jennifer Ann Hales Surgery 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 2020-09-24
1902423387 Center for Vein Restoration Ga Corp Surgery 1100 Johnson Fy Rd Ne Ste 165, Atlanta, GA 30342-1795 2020-07-01
1487133278 Usa Vascular Center of Decatur LLC Surgery 495 Winn Way Ste 230, Decatur, GA 30030-1736 2018-08-13
1841789914 Milner Vein and Vascular LLC Surgery 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 2018-05-04
1023517505 Antioch Vascular Center, LLC Surgery 9104 Middleground Road, Suite 2, Savannah, GA 31406 2018-02-09
1740507425 Christopher Ray Ramos Surgery 1365 Clifton Road Ne, Building A, Room A2200, Atlanta, GA 30322 2010-04-21
1184879678 Rockdale Vascular and Thoracic Surgery, LLC Surgery 1368c Wellbrook Cir Ne, Conyers, GA 30012-3872 2008-11-25
1528218393 Vladimir Zahradnik Surgery 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 2008-09-29
1487819132 Yazan Duwayri Surgery Division of Vascular Surgery Emory Clinic Bldg A, 1365 Clifton Road Ne. 3rd Floor, Atlanta, GA 30322-0001 2008-07-22
1033372610 Robert S Crawford Surgery 5673 Peachtree Dunwoody Ste 675, Atlanta, GA 30342-1774 2008-07-03
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Competitor

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City LAWRENCEVILLE
Zip Code 30046

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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