# M. JANE MOORE, MD. LLC.

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

## Provider details

- **NPI number:** 1609173798
- **Authorized official:** JILL M CARROLL (OFFICE MANAGER)
- **Authorized official phone:** (907) 569-3600

## Contact information

- **Practice address:** 3260 PROVIDENCE DR STE 526, ANCHORAGE, AK 99508-4608
- **Practice address phone:** (907) 569-3600
- **Practice address fax:** (907) 569-3200
- **Mailing address:** 3260 PROVIDENCE DR. STE 526, ANCHORAGE, AK 99508-4608
- **Mailing address phone:** (907) 569-3600
- **Mailing address fax:** (907) 569-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 952570 | AK | Yes |

## Other

- **Enumeration date:** 02/25/2011
- **Last updated:** 02/25/2011