DR. LARRY RUSSELL MOORMAN (NPI# 1518978881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518978881 |
| Entity Type | Individual |
| Full Name | DR. LARRY RUSSELL MOORMAN |
| Credential | M.D. |
| Practice Address |
1803 Old Ocilla Rd Tifton GA 31794-1617 |
| Practice Telephone | 2293862181 |
| Practice Fax Number | 2293862193 |
| Mailing Telephone | 2293862181 |
| Mailing Fax Number | 2293862193 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 014938 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000018334A4 | 05 |
| Street Address |
1803 OLD OCILLA RD |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-1617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336150648 | Robert Jon Holme | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2006-08-11 |
| 1942689690 | William Johnson | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2015-05-28 |
| 1316343452 | Tifton Ophthalmology Associates. PC | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2014-11-18 |
| 1962846352 | Amedco Georgia LLC | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2013-04-29 |
| 1225193329 | Larry R Moorman M D, PC | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2006-12-27 |
| 1841201134 | Bret Bouton Wagenhorst | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1174969281 | Ronald Mitchell Hughes | Ophthalmology | 6307 Forest Lake Dr E, Tifton, GA 31794-2316 | 2013-05-15 |
| 1336150648 | Robert Jon Holme | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2006-08-11 |
| 1942689690 | William Johnson | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2015-05-28 |
| 1316343452 | Tifton Ophthalmology Associates. PC | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2014-11-18 |
| 1962846352 | Amedco Georgia LLC | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2013-04-29 |
| 1225193329 | Larry R Moorman M D, PC | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2006-12-27 |
| 1841201134 | Bret Bouton Wagenhorst | Ophthalmology | 1803 Old Ocilla Rd, Tifton, GA 31794-1617 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748219 | Athens Eye Consultants LLC | Ophthalmology | 650 Oglethorpe Ave Ste 5, Athens, GA 30606-2216 | 2020-10-21 |
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1255974630 | Thomas Eye Group PC | Ophthalmology | 2240 Hamilton Creek Pkwy Ste 1100, Dacula, GA 30019-4515 | 2019-10-18 |
| 1972151462 | Rahul Assa Sharma | Ophthalmology | Emory Eye Center 1365 Clifton Rd B, Atlanta, GA 30322-0001 | 2019-08-28 |
| 1821589441 | Thomas Eye Group PC | Ophthalmology | 1110 W Peachtree St Nw Ste 860, Atlanta, GA 30309-3609 | 2018-05-21 |
| 1609363878 | Patricia Anne Bentley | Ophthalmology | 4712 Polo Ln Se, Atlanta, GA 30339-5328 | 2018-04-13 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1689038986 | Jonathan Shader | Ophthalmology | 1120 15th St # Ba-2720, Augusta, GA 30912-3983 | 2016-04-12 |
| 1467814830 | David Jay Felsted | Ophthalmology | 1120 15th St Ste Ba-2701, Augusta, GA 30912-0004 | 2016-03-24 |
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| 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.