Individual
CHARLES A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2308 E MAIN ST STE B, NEW IBERIA, LA 70560-4029
(337) 369-3683
Mailing address
604 N ACADIA RD STE 101, THIBODAUX, LA 70301-4897
(854) 465-0799
(985) 447-2497
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
327892
LA
207Y00000X
Otolaryngology Physician
57.028402
OH
Other
Enumeration date
03/24/2016
Last updated
03/28/2024
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