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Individual

ROBERT MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
323 WEST WALNUT AVENUE, BASTROP, LA 71220
(318) 323-0838
Mailing address
323 WEST WALNUT AVENUE, BASTROP, LA 71220
(318) 323-0838

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
094741
LA

Other

Enumeration date
11/01/2006
Last updated
11/28/2007
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