Organization
M. JANE MOORE, MD. LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL M CARROLL (OFFICE MANAGER)
(907) 569-3600
Entity
Organization
Contact information
Practice address
3260 PROVIDENCE DR STE 526, ANCHORAGE, AK 99508-4608
(907) 569-3600
(907) 569-3200
Mailing address
3260 PROVIDENCE DR. STE 526, ANCHORAGE, AK 99508-4608
(907) 569-3600
(907) 569-3200
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
952570
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD8920
—
AK
Enumeration date
02/25/2011
Last updated
02/25/2011
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