Individual
DR. CHAD EDWIN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1531 WEST 32ND STREET, SUITE 102, JOPLIN, MO 64804-1651
(417) 781-3630
(417) 781-9814
Mailing address
1531 WEST 32ND STREET, SUITE 102, JOPLIN, MO 64804-1651
(417) 781-3630
(417) 781-9814
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2006017254
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200383240A
—
KS
01
—
212451
BC/BS
MO
05
—
311200307
—
MO
Enumeration date
07/05/2006
Last updated
10/02/2019
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