Individual
JERRY W MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1246 ASHLAND AVE, STE 107, ZANESVILLE, OH 43701
(740) 454-7725
(740) 454-7728
Mailing address
1246 ASHLAND AVE, STE 107, ZANESVILLE, OH 43701
(740) 454-7725
(740) 454-7728
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35043340M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0426239
—
OH
Enumeration date
12/21/2005
Last updated
02/08/2011
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