MR. JUSTIN MOORE PHYSICIAN ASSISTANT NPI 1831743699

NPI Information

  • NPI: 1831743699
  • Provider Name: MR. JUSTIN MOORE, PHYSICIAN ASSISTANT
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1541 KINGS HWY
    SHREVEPORT, LA
    ZIP 71103
  • Phone: (870) 510-0171

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NPI Details

MR. Justin Moore, PHYSICIAN ASSISTANT is a medical physician assistant in Shreveport, LA. MR. Justin Moore, PHYSICIAN ASSISTANT NPI is 1831743699. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1541 KINGS HWY
SHREVEPORT, LA
ZIP 71103-228
Phone: (870) 510-0171

The NPI 1831743699 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 7/30/2019 and was last updated on 5/23/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical346971LOUISIANAYes

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: 11/21/2025

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