Individual
MR. ROBERT WALLACE MOORE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4563 LANDFALL CT, DESTIN, FL 32541-5313
(850) 650-5784
Mailing address
4563 LANDFALL CT, DESTIN, FL 32541-5313
(850) 650-5784
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6287
AL
207XX0801X
Orthopaedic Trauma Physician
6287
AL
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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