Organization
RICHARD E MOORE MEDICAL PA
Active
Organization
RICHARD E MOORE MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRYSTA MCGUIRE (OFFICE ADMIN)
(501) 733-0311
Entity
Organization
Contact information
Practice address
523 HARKRIDER ST, CONWAY, AR 72032-5631
(501) 327-4484
(501) 327-5963
Mailing address
523 HARKRIDER ST, CONWAY, AR 72032-5631
(501) 327-4484
(501) 327-5963
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MC-3139
AR
207LP2900X
Pain Medicine (Anesthesiology) Physician
MC-3139
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC-3139
AR STATE MEDICAL BOARD LICENSE NUMBER
AR
Enumeration date
01/13/2016
Last updated
01/13/2016
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