Individual
DR. JERRY A MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
509 N 2ND ST, HEBER SPRINGS, AR 72543-2513
(501) 362-8191
(501) 362-3096
Mailing address
PO BOX 2, 509 N SECOND STREET, HEBER SPRINGS, AR 72543-0002
(501) 362-8191
(501) 362-3096
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2250
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2220019
UNITED HEALTH
—
01
—
71078816172543
TRICARE
—
Enumeration date
11/02/2005
Last updated
04/17/2008
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