Moore, Benjamin Alan
Moore, Benjamin Alan is an sole proprietor health care provider with primary practice located at 401 W Main St Suite A, John Day OR 97845-1075. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moore, Benjamin Alan can be contacted via phone (541) 575-1819.Contact Information
Primary practice address
401 W Main St Suite A
John Day OR 97845-1075
Phone: (541) 575-1819
Fax: (541) 575-0965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3268ATI | Oregon |
Profile Details
| NPI number | 1548459498 |
|---|---|
| LBN Legal business name | Moore, Benjamin Alan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 16th, 2007 |
| Last updated | Jan 26th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548459498 | NPPES |
| Oregon | MEDICAID | 023687 |
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