Individual
DR. TRUDY ANN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
265 HIGHWAY 15 S, JACKSON, KY 41339-7370
(606) 464-0151
Mailing address
890 LAKESIDE DR, JACKSON, KY 41339-7487
(606) 666-9112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24633
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24633
MEDICAL LICENSE
KY
Enumeration date
01/31/2007
Last updated
03/07/2023
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