Individual
DR. CHRISTOPHER BRYAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5850 US ROUTE 60, SUITE O, ASHLAND, KY 41102-9516
(606) 928-4900
(606) 928-4923
Mailing address
5850 US ROUTE 60, SUITE O, ASHLAND, KY 41102-9516
(606) 928-4900
(606) 928-4923
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00273
KY
213EP0504X
Public Medicine Podiatrist
00273
KY
213EP1101X
Primary Podiatric Medicine Podiatrist
00273
KY
213ER0200X
Radiology Podiatrist
00273
KY
213ES0000X
Sports Medicine Podiatrist
00273
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
00273
KY
213ES0131X
Foot Surgery Podiatrist
00273
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216342
ANTHEM BC AND BS
KY
01
—
371421256
TAX IDENTIFICATION NUMBER
KY
01
—
7774351
AETNA US HEALTHCARE
KY
Enumeration date
02/10/2007
Last updated
02/01/2012
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