Moore, Jeffrey Keith

Moore, Jeffrey Keith is an individual health care provider with primary practice located at 421 Chestnut St , Evansville IN 47713-1227. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Moore, Jeffrey Keith can be contacted via phone (812) 426-9355.

Contact Information

Primary practice address
421 Chestnut St Evansville IN 47713-1227
Phone: (812) 426-9355
Fax: (812) 858-4539
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01029516 Indiana

Profile Details

NPI number 1225105323
LBN Legal business name Moore, Jeffrey Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jan 8th, 2013 - about 12 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 1225105323 NPPES
Indiana Other 000000109394 ANTHEM
Indiana Other 64755457 ANTHEM
Indiana MEDICAID 100078540 ANTHEM
Indiana Other 070005453 ANTHEM

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