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General NPI Number Information
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NPI Number | 1740209253
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Entity Type | Individual
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Provider Name | CHARLES F MOORE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 3897 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-9562
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Country | US
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Telephone | 502-495-3665
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Fax | 502-874-5536
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Provider Business Mailing Address
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Address Line | 3897 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-9562
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Country | US
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Telephone | 502-495-3665
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Fax | 502-874-5536
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 41169
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 41169
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01056663A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 01056663A
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License Number State | IN
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