Individual
THOMAS CHARLES MOFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E PRIMROSE, SPRINGFIELD, MO 65807
(417) 875-3761
(417) 875-3245
Mailing address
1001 E PRIMROSE, SPRINGFIELD, MO 65807
(417) 875-3761
(417) 875-3245
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
R7J30
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106984
BLUE CROSS/BLUE SHIELD
—
05
—
202678207
—
MO
Enumeration date
06/06/2006
Last updated
07/05/2012
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