Individual
JEFFREY KEITH MOONAN
Active
Individual
JEFFREY KEITH MOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11825
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1171514
—
LA
01
—
232758
WELLCARE
LA
01
—
2500230
UNITED HEALTHCARE
LA
01
—
4211647
AETNA
LA
Enumeration date
08/19/2005
Last updated
07/09/2007
Update your record
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