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NPI Code Detail

MEDICARE: JAMES LAYNE MOORE MD

MEDICARE: JAMES LAYNE MOORE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician35057677OH
22084N0600XClinical Neurophysiology Physician35057677OH
32084S0012XSleep Medicine (Psychiatry & Neurology) Physician35057677OH
42084N0400XNeurology Physician35068MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730264037
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES LAYNE MOORE MD
Provider Business Mailing Address
First Line : 30 E APPLE ST
Second Line : SUITE 5254
City : DAYTON
State : OH
Zip : 45409-2939
Country : US
Telephone Number : 937-208-4200
Fax Number : 937-208-4205
Provider Business Practice Location Address
First Line : 300 STATE AVE
Second Line :
City : FARIBAULT
State : MN
Zip : 55021-6319
Country : US
Telephone Number : 507-333-3300
Fax Number : 507-333-3387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/21/2022

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