Moore, Michael Kirk
Moore, Michael Kirk is an sole proprietor health care provider with primary practice located at 2860 Channing Way Suite 213, Idaho Falls ID 83404-7531. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Moore, Michael Kirk can be contacted via phone (208) 552-1406.Contact Information
Primary practice address
2860 Channing Way Suite 213
Idaho Falls ID 83404-7531
Phone: (208) 552-1406
Fax: (208) 552-1416
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | M-8270 | Idaho |
Profile Details
| NPI number | 1306064860 |
|---|---|
| LBN Legal business name | Moore, Michael Kirk |
| Credentials | M.D., P.C. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 23rd, 2007 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1306064860 | NPPES |
| Idaho | Other | M-8270 | MEDICAL LICENSE, ID |
| Idaho | Other | 5959620-1205 | MEDICAL LICENSE, ID |
| Idaho | Other | 58MKM02 | MEDICAL LICENSE, ID |
| Idaho | Other | 5959620-8905 | MEDICAL LICENSE, ID |
| Idaho | Other | 6687A | MEDICAL LICENSE, ID |
| Idaho | Other | CS9201 | MEDICAL LICENSE, ID |
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