Individual
MR. JEFFERSON WILBURN MOORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1710 HARRISON ST, BATESVILLE, AR 72501-7303
(870) 262-1338
(870) 262-1336
Mailing address
1710 HARRISON ST, BATESVILLE, AR 72501-7303
(870) 262-1338
(870) 262-1336
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ATP-000312
AR
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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