Organization
MOORE FAMILY EYECARE, LLC
Active
Organization
MOORE FAMILY EYECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS LORAN MOORE O.D. (MEMBER)
(417) 926-3937
Entity
Organization
Contact information
Practice address
1902 WEST 19TH STREET, STE. A, MOUNTAIN GROVE, MO 65711-1221
(417) 926-3937
(417) 926-3952
Mailing address
1902 WEST 19TH STREET, STE. A, MOUNTAIN GROVE, MO 65711-1221
(417) 926-3937
(417) 926-3952
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
T03463
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317443505
—
MO
Enumeration date
06/04/2010
Last updated
02/20/2017
Update your record
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