Moore, Henry R

Moore, Henry R is an sole proprietor health care provider with primary practice located at 611 W Park St , Urbana IL 61801-2529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Moore, Henry R can be contacted via phone (217) 383-3240.

Contact Information

Primary practice address
611 W Park St Urbana IL 61801-2529
Phone: (217) 383-3240
Fax: (217) 383-4597
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD036123 District of Columbia
Allopathic & Osteopathic Physicians / Surgery 208600000X 036119986 Illinois

Profile Details

NPI number 1932392099
LBN Legal business name Moore, Henry R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2007
Last updated Mar 31st, 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 1932392099 NPPES
Other 0533210001 DMERC
MEDICAID 036119986 DMERC

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