Physician Compare National (NPI:1306920913)

HEALTHCARE PROVIDER: LEE RICHARD MOORE JR. O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306920913
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345251344
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060505000023
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOORE
	Individual professional last name
Provider First Name	LEE
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	OD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	SOUTHERN COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	311 PROSPECT AVE
	Group Practice or individual's line 1 address
City	CHARLES TOWN
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	254141137
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3047251411
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y