Moe, Jordan Robert

Moe, Jordan Robert is an individual health care provider with primary practice located at 49725 County 83 , Staples MN 56479-5280. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Moe, Jordan Robert can be contacted via phone (218) 894-1515.

Contact Information

Primary practice address
49725 County 83 Staples MN 56479-5280
Phone: (218) 894-1515
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 52007 Minnesota

Profile Details

NPI number 1033386966
LBN Legal business name Moe, Jordan Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2008
Last updated Dec 14th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033386966 NPPES
Wisconsin Other 1033386966 GROUP HEALTH
Wisconsin Other P00767161 GROUP HEALTH
Wisconsin MEDICAID 1033386966 GROUP HEALTH
Wisconsin Other 01-37339 GROUP HEALTH
Wisconsin Other 1033386966 GROUP HEALTH

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