Moore, Jack
Moore, Jack is an individual health care provider with primary practice located at 3800 Reservoir Rd Nw , Washington DC 20007-2113. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Moore, Jack can be contacted via phone (202) 877-6034.Contact Information
Primary practice address
3800 Reservoir Rd Nw
Washington DC 20007-2113
Phone: (202) 877-6034
Fax: (202) 877-8329
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | MD19916 | District of Columbia |
Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | MD19916 | District of Columbia |
Profile Details
NPI number | 1467426221 |
---|---|
LBN Legal business name | Moore, Jack |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 16th, 2006 |
Last updated | Jun 16th, 2015 - about 10 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 | 1467426221 | NPPES |
District of Columbia | MEDICAID | 025615700 | |
District of Columbia | MEDICAID | 042931700 | |
District of Columbia | MEDICAID | 5817889 |
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