Moore, John T
Moore, John T is an individual health care provider with primary practice located at 12303 Depaul Drive Medical Staff Office, Bridgeton MO 63044. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Moore, John T can be contacted via phone (314) 344-6071.Contact Information
Primary practice address
12303 Depaul Drive Medical Staff Office
Bridgeton MO 63044
Phone: (314) 344-6071
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2004005496 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2004005496 | Missouri |
Profile Details
| NPI number | 1356399323 |
|---|---|
| LBN Legal business name | Moore, John T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Jul 19th, 2011 - about 13 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 | 1356399323 | NPPES |
| Missouri | MEDICAID | 208738401 |
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