Individual
DR. THOMAS J MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7 WEST 7TH ST, COVINGTON, KY 41011-2301
(859) 431-7966
Mailing address
7 WEST 7TH ST, COVINGTON, KY 41011-2301
(859) 431-7966
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
996DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000033554
ANTHEM
—
05
—
77009967
—
KY
Enumeration date
02/02/2006
Last updated
11/23/2010
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