Individual
JAMES LAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 STATE AVE, FARIBAULT, MN 55021-6319
(507) 333-3300
(507) 333-3387
Mailing address
30 E APPLE ST, SUITE 5254, DAYTON, OH 45409-2939
(937) 208-4200
(937) 208-4205
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
35057677
OH
2084N0400X
Neurology Physician
Primary
35068
MN
2084N0600X
Clinical Neurophysiology Physician
35057677
OH
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
35057677
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0764605
—
OH
Enumeration date
10/26/2006
Last updated
07/21/2022
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