Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Moon Lake Emergency Physicians LLC

Organization Emergency Medicine Physician · NPI 1831561455

Moon Lake Emergency Physicians LLC is an Emergency Medicine Physician in Phenix City, Alabama. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4401 River Chase Dr
Phenix City, AL 36867-7483
Phone: (469) 401-2386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X

Record details

NPI number1831561455
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kathleen Kondas — Officer · (954) 838-2371
NPI enumeratedOctober 22, 2015
Last updated in NPPESSeptember 10, 2019
Mailing address13737 Noel Rd, Ste 1600, Dallas, TX 75240-1331

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