# GENE MOORE MD P LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437671377
- **Authorized official:** MRS. DEB A CAISE (OFFICE MANAGER)
- **Authorized official phone:** (802) 864-7080

## Contact information

- **Practice address:** 28 SO WILLIAMS ST, BURLINGTON, VT 05401
- **Practice address phone:** (802) 864-7080
- **Practice address fax:** (802) 863-0411
- **Mailing address:** 28 S WILLIAMS ST, BURLINGTON, VT 05401-3486
- **Mailing address phone:** (802) 864-7080
- **Mailing address fax:** (802) 863-0411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 042010189 | VT | Yes |

## Other

- **Enumeration date:** 07/12/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00058102 | BLUE CROSS BLUE SHIELD | VT |
| 05 | — | OVN2573 | — | VT |