Provider Demographics
NPI:1174564918
Name:MOODY, PATRICIA GISSENDANNER (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:GISSENDANNER
Last Name:MOODY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:44 HUGHES RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2237
Mailing Address - Country:US
Mailing Address - Phone:256-772-2037
Mailing Address - Fax:256-772-9523
Practice Address - Street 1:44 HUGHES RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2237
Practice Address - Country:US
Practice Address - Phone:256-772-2037
Practice Address - Fax:256-772-9523
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL27248208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics