Individual
DR. M KENT MOORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
564 W 9TH PL, STE 3, MESA, AZ 85201-4069
(480) 834-3868
(480) 833-0763
Mailing address
564 W 9TH PL, STE 3, MESA, AZ 85201-4069
(480) 834-3868
(480) 833-0763
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
8097
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120367
HEALTHNET
AZ
01
—
4654696
AETNA
—
01
—
AZ0377870
BCBS
AZ
Enumeration date
07/14/2005
Last updated
07/08/2007
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