Individual
DR. BRIAN ANDREW MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
307 BOATNER RD, SUITE 114, EGLIN AFB, FL 32542-1391
(850) 883-8264
(850) 883-8253
Mailing address
307 BOATNER RD, SUITE 114, EGLIN AFB, FL 32542-1391
(850) 883-8264
(850) 883-8253
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
L7051
TX
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD.200570
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04630817
—
MS
05
—
1465917
—
LA
Enumeration date
01/09/2006
Last updated
09/03/2009
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