Individual
ETHEL LAMAR MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
RR 1 BOX 67, HARLEM, MT 59526-9705
(406) 353-3100
(406) 353-3229
Mailing address
RR 1 BOX 77, HARLEM, MT 59526-9706
(406) 353-3137
(406) 353-3229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C 6449
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-6449
LICENSE
AR
Enumeration date
03/21/2007
Last updated
02/01/2008
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