Moore, Jon G.

Moore, Jon G. is an individual health care provider with primary practice located at 608 Old Route 66 , Saint Robert MO 65584-3730. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Moore, Jon G. can be contacted via phone (573) 336-5100.

Contact Information

Primary practice address
608 Old Route 66 Saint Robert MO 65584-3730
Phone: (573) 336-5100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 118222 Missouri

Profile Details

NPI number 1003805201
LBN Legal business name Moore, Jon G.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2005
Last updated Mar 13th, 2014 - about 11 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 1003805201 NPPES
Missouri Other 431560263 TRICARE
Missouri Other P01262378 TRICARE

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