Moore, Chad Edwin
Moore, Chad Edwin is an sole proprietor health care provider with primary practice located at 1531 West 32Nd Street Suite 102, Joplin MO 64804-1651. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moore, Chad Edwin can be contacted via phone (417) 781-3630.Contact Information
Primary practice address
1531 West 32Nd Street Suite 102
Joplin MO 64804-1651
Phone: (417) 781-3630
Fax: (417) 781-9814
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2006017254 | Missouri |
Profile Details
| NPI number | 1700817210 |
|---|---|
| LBN Legal business name | Moore, Chad Edwin |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Oct 2nd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700817210 | NPPES |
| Kansas | MEDICAID | 200383240A | |
| Kansas | Other | 212451 | |
| Kansas | MEDICAID | 311200307 |
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