Organization
CHARLES A MOORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES A MOORE MD (OWNER)
(606) 248-0090
Entity
Organization
Contact information
Practice address
123 N 19TH ST, SUITE 201, MIDDLESBORO, KY 40965-2865
(606) 248-7630
(606) 248-8803
Mailing address
PO BOX 309, MIDDLESBORO, KY 40965-0309
(606) 248-7630
(606) 248-8803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2007
Last updated
01/21/2025
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