Individual
DR. GERALD L MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 NEWBURG RD, LOUISVILLE, KY 40205-1803
(502) 479-4000
Mailing address
PO BOX 5638, LOUISVILLE, KY 40255-0638
(502) 363-1312
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
14100
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389000 A
—
IN
05
—
64-141005
—
KY
Enumeration date
08/31/2006
Last updated
03/16/2009
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