Moon Jr, Kenneth H

Moon Jr, Kenneth H is an individual health care provider with primary practice located at 2301 East 14Th Street , Des Moines IA 50316-1901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Moon Jr, Kenneth H can be contacted via phone (515) 262-0404.

Contact Information

Primary practice address
2301 East 14Th Street Des Moines IA 50316-1901
Phone: (515) 262-0404
Fax: (515) 262-0489
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 02033 Iowa

Profile Details

NPI number 1447226840
LBN Legal business name Moon Jr, Kenneth H
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Aug 9th, 2012 - about 13 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 1447226840 NPPES
Iowa MEDICAID 1447226840
Iowa MEDICAID 2215236

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