Individual
PAUL M MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 PARK ST, SUITE 210, BOWLING GREEN, KY 42101-1784
(270) 796-3330
(270) 796-3338
Mailing address
PO BOX 2697, BOWLING GREEN, KY 42102-7697
(270) 745-1467
(270) 745-1417
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
32916
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64329162
—
KY
Enumeration date
07/19/2005
Last updated
07/08/2007
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