Individual
PAUL E MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 3RD ST STE 250, HENDERSON, KY 42420-5802
(270) 826-0135
(270) 827-8798
Mailing address
471 KLUTEY PARK PLAZA DR, HENDERSON, KY 42420-3347
(270) 830-6100
(270) 826-3089
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22393
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000062228
ANTHEM
—
05
—
64223936
—
KY
Enumeration date
04/12/2006
Last updated
03/11/2019
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