Individual
DR. JEAN N MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
70366
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124444828
MO BLUE SHIELD
MO
05
—
137514001
—
AR
05
—
207814815
—
MO
01
—
98575
ARK BLUE SHIELD
AR
Enumeration date
02/13/2007
Last updated
04/08/2024
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