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Contact Information

CHARLES B MOOMEY JR, MD
725 JESSE JEWELL PKWY SE
GAINESVILLE, GA30501-3834
 Phone: 678-207-4000
 Fax: 770-531-2435
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for CHARLES B MOOMEY JR · (Male)

NPI # 1689671364
Status Active
Credentials MD
Entity Individual
Enumeration date 07/07/2005
Last updated 06/11/2025 - About 12 months ago
Sole proprietor 1 No
Identifiers
  • GA License # 049923
  • GA Medicaid 00899951A
  • GA Other GRP7416 MEDICARE GROUP NUMBER
Hospital affiliation(s)
  • GWINNETT MEDICAL CENTER - (Acute Care)
    1000 MEDICAL CENTER BOULEVARD
    LAWRENCEVILLE, GA 30045
  • NORTHEAST GEORGIA MEDICAL CENTER INC - (Acute Care)
    743 SPRING STREET
    GAINESVILLE, GA 30501
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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