Individual
ROBERT A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1400 W CENTRAL AVE, EL DORADO, KS 67042-2201
(316) 320-2200
(316) 321-0430
Mailing address
1851 N WEBB RD, ATTN FLR2, WICHITA, KS 67206-3413
(316) 636-2010
(316) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12632
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100219320B
—
KS
01
—
410029647
RAILROAD MEDICARE
KS
Enumeration date
02/23/2006
Last updated
12/06/2013
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