Moore, Matthew Henry

Moore, Matthew Henry is an individual health care provider with primary practice located at 111 S Treaty Rd , Miami OK 74354. 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, Matthew Henry can be contacted via phone (918) 540-1511.

Contact Information

Primary practice address
111 S Treaty Rd Miami OK 74354
Phone: (918) 540-1511
Fax: (918) 542-7374
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1732 Oklahoma

Profile Details

NPI number 1700053394
LBN Legal business name Moore, Matthew Henry
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2008
Last updated Jan 7th, 2019 - about 6 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 1700053394 NPPES
Oklahoma MEDICAID 200207110A
Oklahoma MEDICAID 100736700O

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