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Organization

KENNETH P MOORE, MD

Active
Other names
DBA Ruby Valley Urology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH PAGE MOORE MD (CEO RUBY VALLEY UROLOGY)
(775) 738-2218
Entity
Organization

Contact information

Practice address
1995 ERRECART BLVD, SUITE 207, ELKO, NV 89801-8337
(775) 738-2218
Mailing address
1995 ERRECART BLVD, SUITE 207, ELKO, NV 89801-8337
(775) 738-2218
(775) 738-2219

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100506958
NV
Enumeration date
11/07/2006
Last updated
06/23/2008
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