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Individual

DR. THOMAS C MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
701 N UNIVERSITY AVE, SUITE 100, LITTLE ROCK, AR 72205
(501) 664-4810
(501) 663-1256
Mailing address
701 N UNIVERSITY AVE STE 100, LITTLE ROCK, AR 72205-2936
(501) 664-4810
(501) 663-1256

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-6856
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-20140
UNITED HEALTHCARE
AR
01
080102392
MEDICARE RAILROAD
AR
01
080102392
RAILROAD MEDICARE
01
12448000000
QUALCHOICE
AR
Enumeration date
08/26/2005
Last updated
07/14/2020
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