Individual
DR. PAUL DEAN MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7840 W 165TH ST STE 210, OVERLAND PARK, KS 66223
(913) 373-2230
(913) 373-0999
Mailing address
7840 W 165TH ST STE 210, OVERLAND PARK, KS 66223-2993
(913) 373-2230
(913) 373-0999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0430003
KS
208000000X
Pediatrics Physician
Primary
0430003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100457270A
—
KS
Enumeration date
05/17/2006
Last updated
06/27/2018
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