Moore, Jason L

Moore, Jason L is an individual health care provider with primary practice located at 45 10Th St W , Saint Paul MN 55102-1062. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Moore, Jason L can be contacted via phone (651) 232-3000.

Contact Information

Primary practice address
45 10Th St W Saint Paul MN 55102-1062
Phone: (651) 232-3000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 61613 Minnesota
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4301080458 Michigan
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4301080458 Michigan
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 39945 Iowa

Profile Details

NPI number 1720049109
LBN Legal business name Moore, Jason L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Nov 16th, 2020 - about 4 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 1720049109 NPPES
Michigan MEDICAID 104715823
Michigan MEDICAID 104785416
Michigan MEDICAID 104785425
Michigan Other JM080458

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