Organization
JOHN M MOORE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M MOORE M.D. (PRESIDENT)
(816) 363-4114
Entity
Organization
Contact information
Practice address
6400 PROSPECT AVE, SUITE 238, KANSAS CITY, MO 64132-1100
(816) 363-4114
(816) 363-5558
Mailing address
6400 PROSPECT AVE, SUITE 238, KANSAS CITY, MO 64132-1100
(816) 363-4114
(816) 363-5558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MDR3B83
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12752023
BCBS OF KC GROUP ID #
MO
Enumeration date
04/26/2007
Last updated
03/19/2013
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