Individual
MR. GLENN I MOORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 NICHOLASVILLE RD, SUITE 400, LEXINGTON, KY 40503-1475
(859) 278-0363
(859) 277-6938
Mailing address
1720 NICHOLASVILLE RD, SUITE 400, LEXINGTON, KY 40503-1475
(859) 278-0363
(859) 277-6938
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
15567
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64155674
—
KY
Enumeration date
10/27/2005
Last updated
07/08/2007
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