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General NPI Number Information
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NPI Number | 1790719417
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Entity Type | Individual
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Provider Name | JOSEPH ANDREW MOORE MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 1500 N OAKLAND AVE
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City | BOLIVAR
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State | MO
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Zip | 65613
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Country | US
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Telephone | 417-328-6040
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Fax |
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Provider Business Mailing Address
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Address Line | 800 N JUSTICE ST BOX 16
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-3410
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Country | US
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Telephone | 828-694-8350
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Fax | 828-694-7654
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME86388
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 9600647
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 2011007291
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License Number State | MO
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