Individual
DARLENE A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1103 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751
(573) 756-1965
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(573) 756-6751
(573) 756-1965
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R6D31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209703016
—
MO
Enumeration date
10/25/2006
Last updated
07/14/2016
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