Moore, Gary Randall

Moore, Gary Randall is an individual health care provider with primary practice located at 515 Read St , Evansville IN 47710-1739. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Moore, Gary Randall can be contacted via phone (812) 424-9291.

Contact Information

Primary practice address
515 Read St Evansville IN 47710-1739
Phone: (812) 424-9291
Fax: (812) 421-2722
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 01030659A Indiana

Profile Details

NPI number 1386647972
LBN Legal business name Moore, Gary Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Nov 26th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386647972 NPPES
Indiana MEDICAID 100179870
Indiana Other 000000067659
Indiana Other 0231480001

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