Individual
AARON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 N 8TH ST STE 3B, SPRINGFIELD, IL 62701-1041
(217) 545-7123
(217) 545-7305
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036.167755
IL
208800000X
Urology Physician
65701
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036167755
—
IL
05
—
Q074833
—
TN
Enumeration date
03/28/2016
Last updated
09/17/2024
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