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Organization

A T STILL UNIVERSITY OF HEALTH SCIENCES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ADAM MOORE (CLINIC MANAGER)
(660) 626-2739
Entity
Organization

Contact information

Practice address
800 W JEFFERSON ST, KIRKSVILLE, MO 63501-1443
(660) 626-2739
(660) 626-2150
Mailing address
800 W JEFFERSON ST, KIRKSVILLE, MO 63501-1443
(660) 626-2739
(660) 626-2150

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
207Q00000X
Family Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
2084N0400X
Neurology Physician
208600000X
Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500772306
MO
01
CH0404
PALMETTO GBA-RR MEDICARE
MO
Enumeration date
04/06/2006
Last updated
02/18/2026
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