Individual
DR. JACOB MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4400 EMILE ST, OMAHA, NE 68198-0600
(402) 552-6007
Mailing address
4400 EMILE ST, OMAHA, NE 68198-0600
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NE
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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