Moore, Bradley T

Moore, Bradley T is an individual health care provider with primary practice located at 100 Airport Gardens Rd , Hazard KY 41701-9529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Moore, Bradley T can be contacted via phone (606) 377-3427.

Contact Information

Primary practice address
100 Airport Gardens Rd Hazard KY 41701-9529
Phone: (606) 377-3427
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X TP003 Kentucky

Profile Details

NPI number 1629062807
LBN Legal business name Moore, Bradley T
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jan 21st, 2022 - about 2 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 1629062807 NPPES
Kentucky MEDICAID 64106719

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