Individual
WILLARD ANSON MOORE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-3970
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101257667
VA
207X00000X
Orthopaedic Surgery Physician
Primary
311241
LA
207X00000X
Orthopaedic Surgery Physician
53975
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101257667
LICENSE
VA
Enumeration date
06/19/2008
Last updated
03/07/2023
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