Individual
DR. PHILLIP MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3609 HIGHWAY 367 N, BALD KNOB, AR 72010-9404
(501) 724-2202
(501) 724-2202
Mailing address
PO BOX 1609, 3609 HWY 367 N, BALD KNOB, AR 72010-1609
(501) 724-2202
(501) 724-2202
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1083
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150110718
—
AR
01
—
5187337
AETNA
AR
01
—
59073
BLUE CROSS
AR
Enumeration date
03/24/2006
Last updated
08/30/2010
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