| Charles a Moore | |
|
123 N 19th St Suite 201 Middlesboro KY 40965-2865 | |
| (606) 248-7630 | |
| (606) 248-8803 |
| Full Name | Charles a Moore |
|---|---|
| Speciality | Clinic/center |
| Location | 123 N 19th St, Middlesboro, Kentucky |
| Authorized Official Name and Position | Charles a Moore (OWNER) |
| Authorized Official Contact | 6062480090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles a Moore Po Box 309 Middlesboro KY 40965-0309 Ph: (606) 248-7630 | Charles a Moore 123 N 19th St Suite 201 Middlesboro KY 40965-2865 Ph: (606) 248-7630 |
| NPI Number | 1659551935 |
|---|---|
| Provider Enumeration Date | 11/05/2007 |
| Last Update Date | 01/21/2025 |
| Certification Date | 01/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659551935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261Q00000X | Clinic/center | () | Primary |
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