Moore, Charles A

Moore, Charles A is an sole proprietor health care provider with primary practice located at 123 N 19Th St Suite 201, Middlesboro KY 40965-2865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Moore, Charles A can be contacted via phone (606) 248-0090.

Contact Information

Primary practice address
123 N 19Th St Suite 201 Middlesboro KY 40965-2865
Phone: (606) 248-0090
Fax: (606) 248-8803
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22757 Kentucky

Profile Details

NPI number 1003816372
LBN Legal business name Moore, Charles A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2005
Last updated Apr 27th, 2010 - about 15 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 1003816372 NPPES
Kentucky Other 017423400 BLACK LUNG
Kentucky MEDICAID 1003816372 BLACK LUNG
Kentucky Other 000000251586 BLACK LUNG
Kentucky Other 1635649000 BLACK LUNG
Kentucky Other 000051203 BLACK LUNG
Kentucky Other 000000062741 BLACK LUNG
Kentucky Other 110196198 BLACK LUNG
Kentucky MEDICAID 64227572 BLACK LUNG
Kentucky Other 1143 BLACK LUNG
Kentucky Other 4176527 BLACK LUNG
Kentucky Other 1326780 BLACK LUNG
Kentucky Other 1659551935 BLACK LUNG
Kentucky Other 006064205 BLACK LUNG

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