NPI 1114977550

John Russell Moore, MD

Practitioner Urology Physician Independence, MO

Practice location

Address: 19001 E 48th St S, Independence, MO 64055
Phone: (816) 836-8831
Fax: (816) 795-0144

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 2001004851 (MO)

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Registry record

NPI: 1114977550
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 May 2006
Record last updated: 21 Sep 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.