Mr Jeffery W Moore, CRNA is a
Nurse Anesthetist, Certified Registered based in Tipton, Indiana. Mr Jeffery W Moore is licensed to practice in Indiana (license number 28087122A) and his current practice location is
1000 S Main St, Tipton, Indiana. He can be reached at his office (for appointments etc.) via phone at
(765) 675-8521.
NPI number for Mr Jeffery W Moore is 1801870480 and his current mailing address is 1000 S Main St, Tipton, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1801870480.
Provider's Profile
| Full Name | Mr Jeffery W Moore |
|---|
| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1000 S Main St, Tipton, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1801870480
- Provider Enumeration Date: 12/06/2005
- Last Update Date: 10/01/2014
Medical Identifiers
Medical identifiers for Mr Jeffery W Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801870480 | NPI | - | NPPES |
| 200345230A | Medicaid | IN | |
| 200345230 | Medicaid | IN | |
| 000000603596 | Other | IN | ANTHEM - TIPTON HOSPITAL |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367H00000X | Anesthesiologist Assistant | 28087122 (Indiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 28087122A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jeffery W Moore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jeffery W Moore, CRNA
1000 S Main St,
Tipton, IN 46072-9753
Ph: (765) 675-8521 | Mr Jeffery W Moore, CRNA
1000 S Main St,
Tipton, IN 46072-9753
Ph: (765) 675-8521 |
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