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MARY MOORE MD NPI 1770674640


NPI Information

NPI: 1770674640
Provider Name: MARY MOORE, MD
Classification: Radiology - 2085P0229X
Entity Type: Individual

Specialization: Pediatric Radiology

PECOS Registration: Yes

Address:
4301 W MARKHAM ST # 783
LITTLE ROCK, AR
ZIP 72205
Phone: (501) 686-8000
Get Directions

Mary Moore, MD is a pediatric radiology radiology in Little Rock, AR with 32 years of experience. The provider is a radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. Mary Moore, MD NPI is 1770674640. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1992

The provider's business location address is:

4301 W MARKHAM ST # 783
LITTLE ROCK, AR
ZIP 72205-101
Phone: (501) 686-8000

The NPI 1770674640 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/27/2006 and was last updated on 7/31/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085P0229XRadiologyPediatric RadiologyE-2215ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G59635MEDICARE UPIN
25L166MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.