Moore, Jerry Lee
Moore, Jerry Lee is an individual health care provider with primary practice located at 1351 E Spruce Ave , Fresno CA 93720-3342. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Moore, Jerry Lee can be contacted via phone (559) 432-3303.Contact Information
Primary practice address
1351 E Spruce Ave
Fresno CA 93720-3342
Phone: (559) 432-3303
Fax: (559) 432-1468
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | A206180 | California |
Profile Details
| NPI number | 1396705547 |
|---|---|
| LBN Legal business name | Moore, Jerry Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1396705547 | NPPES |
| California | MEDICAID | 00A206180 |
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