Individual
JEFFREY RYAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-3149
Mailing address
NAVAL HOSPITAL TWENTYNINE PALMS, 1145 STURGIS RD, TWENTYNINE PALMS, CA 92278
(760) 830-2082
(760) 830-5264
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101254499
VA
Other
Enumeration date
02/09/2012
Last updated
04/16/2016
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