Individual
DR. JOHN MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 HARRODSBURG RD STE B75, LEXINGTON, KY 40504
(859) 276-3883
(859) 276-3855
Mailing address
1401 HARRODSBURG RD, SUITE B488, LEXINGTON, KY 40504-3751
(859) 276-3883
(859) 276-3855
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
20795
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64207954
—
KY
Enumeration date
03/27/2006
Last updated
08/16/2018
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