Individual
DR. RICHARD EUGENE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
523 HARKRIDER ST, CONWAY, AR 72032
(501) 504-6959
(501) 327-5963
Mailing address
3040 WESTOVER DR, CONWAY, AR 72032-8872
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
35984
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
E9341
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0280378073
—
IL
01
—
105181
BLUE CROSS BLUE SHIELD
MO
01
—
178136
HEALTHLINK
—
05
—
201580115
—
MO
01
—
4691938
AETNA
—
01
—
5BG40
ARKANSAS BLUE CROSS
—
01
—
MA6957001
MEDICARE PART B
MO
01
—
P01625775
RAILROAD MEDICARE
—
Enumeration date
08/30/2006
Last updated
07/18/2018
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