Individual
DR. KEVIN LEE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
612 NW 42ND ST, OKLAHOMA CITY, OK 73118-7004
(405) 397-7159
Mailing address
612 NW 42ND ST, OKLAHOMA CITY, OK 73118-7004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16453
OK
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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