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Individual

DR. GREGORY W. MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 MARY ST, EVANSVILLE, IN 47747-0001
(812) 450-3405
(812) 450-3099
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-6815
(812) 450-6822

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01039918A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000378774
BCBS - DEACONESS PIN
IN
05
64221641
KY
Enumeration date
12/27/2005
Last updated
07/09/2007
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