Individual
BARRY C MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
740 S LIMESTONE, LEXINGTON, KY 40536-0001
(859) 323-5661
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 257-7910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA148
KY
363AM0700X
Medical Physician Assistant
PA148
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95002457
—
KY
Enumeration date
08/09/2006
Last updated
04/15/2008
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