NPI 1003805201

Jon G. Moore, PAC

Practitioner Physician Assistant Saint Robert, MO

Practice location

Address: 608 Old Route 66, Saint Robert, MO 65584-3730
Phone: (573) 336-5100
Mailing address: PO Box 2580, Springfield, MO 65801-2580

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 118222 (MO)

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Registry record

NPI: 1003805201
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Oct 2005
Record last updated: 13 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.