Organization
CORBIN LONDON MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN E. MOORE M.D. (PRESIDENT/OWNER)
(606) 528-0305
Entity
Organization
Contact information
Practice address
1007 CUMBERLAND FALLS HWY, CORBIN, KY 40701
(606) 528-0305
(606) 523-4368
Mailing address
1007 CUMBERLAND FALLS HWY, CORBIN, KY 40701
(606) 528-0305
(606) 523-4368
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1033143
KY
207Q00000X
Family Medicine Physician
1086037
KY
207R00000X
Internal Medicine Physician
39404
KY
208100000X
Physical Medicine & Rehabilitation Physician
002008
KY
Other
Enumeration date
04/22/2008
Last updated
07/28/2011
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