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JESSE D MOORE MD NPI 1790718906


NPI Information

NPI: 1790718906
Provider Name: JESSE D MOORE MD
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
HIGHWAY 64 EAST
AUGUSTA, AR
ZIP 72006
Phone: (870) 347-2568
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JESSE D MOORE MD is a family medicine in Augusta, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JESSE D MOORE MD NPI is 1790718906. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

HIGHWAY 64 EAST
AUGUSTA, AR
ZIP 72006
Phone: (870) 347-2568
Fax: (870) 347-2560

The provider's authorized official is Jesse D Moore .
The authorized official title is Md and has the following contact phone number (870) 347-2568.

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


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
1207Q00000XFamily MedicineYes

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
15J323MEDICARE PINARKANSAS
2F74938MEDICARE UPIN

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: 11/14/2023

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