Individual
MERWIN B MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
639 BROADMOOR CIRCLE, MOUNTAIN HOME, AR 72653
(870) 424-4710
(870) 424-4780
Mailing address
639 BROADMOOR CIRCLE, MOUNTAIN HOME, AR 72653
(870) 424-4710
(870) 424-4780
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2003027560
MO
207X00000X
Orthopaedic Surgery Physician
Primary
E5667
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154348001
—
AR
05
—
209057108
—
MO
01
—
5H201
BCBS - ARKANSAS
AR
Enumeration date
02/09/2006
Last updated
08/09/2012
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