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General NPI Number Information
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NPI Number | 1427258276
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Entity Type | Individual
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Provider Name | BRIAN ALEXANDER MOORE O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 9970 MOUNTAIN VIEW DR SUITE 200
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City | WEST MIFFLIN
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State | PA
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Zip | 15122-2474
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Country | US
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Telephone | 412-653-3080
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Fax | 412-653-3580
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Provider Business Mailing Address
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Address Line | PO BOX 644214
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City | PITTSBURGH
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State | PA
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Zip | 15264-4214
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Country | US
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Telephone | 412-653-3080
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Fax | 412-650-8963
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001932
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License Number State | PA
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