Organization
M B MOORE MD ORTHOPAEDIC SURGEON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MERWIN B MOORE III M.D. (OWNER)
(870) 424-4710
Entity
Organization
Contact information
Practice address
628 HOSPITAL DR, SUITE E, MOUNTAIN HOME, AR 72653-2953
(870) 424-4710
(870) 424-4780
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(479) 968-4273
(479) 968-1363
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180094002
—
AR
01
—
5G230
BCBS
AR
Enumeration date
11/18/2009
Last updated
06/25/2010
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