Individual
ROBERT KEITH MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2831 NEW HARTFORD RD, OWENSBORO, KY 42303-1320
(270) 926-4100
Mailing address
2831 NEW HARTFORD RD, OWENSBORO, KY 42303-1320
(270) 926-4100
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26221
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
26221
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000052294
ANTHEM
KY
01
—
200022274
RAILROAD MEDICARE
KY
05
—
64262215
—
KY
01
—
K005560
TRICARE
KY
Enumeration date
05/24/2005
Last updated
12/07/2022
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