Organization
RICHARD E. MOORE, M.D.
Active
Other names
Ada Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD MOORE M.D. (M.D.)
(208) 377-0777
Entity
Organization
Contact information
Practice address
6500 W EMERALD ST, BOISE, ID 83704-8736
(208) 377-0777
(208) 377-1070
Mailing address
6500 W EMERALD ST, BOISE, ID 83704-8736
(208) 377-0777
(208) 377-1070
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M5456
ID
207X00000X
Orthopaedic Surgery Physician
M8524
ID
363A00000X
Physician Assistant
PA370
ID
Other
Enumeration date
06/06/2007
Last updated
07/06/2010
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