Individual
DR. THOMAS WALTER MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1 STEWART PLZ, DUNBAR, WV 25064-3041
(304) 768-3332
(304) 768-5115
Mailing address
1 STEWART PLZ, DUNBAR, WV 25064-3041
(304) 768-3332
(304) 768-5115
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1061-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810018613
—
WV
Enumeration date
07/13/2009
Last updated
07/13/2021
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