Moore, Jack

Moore, Jack is an individual health care provider with primary practice located at 3800 Reservoir Rd Nw , Washington DC 20007-2113. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Moore, Jack can be contacted via phone (202) 877-6034.

Contact Information

Primary practice address
3800 Reservoir Rd Nw Washington DC 20007-2113
Phone: (202) 877-6034
Fax: (202) 877-8329
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD19916 District of Columbia
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD19916 District of Columbia

Profile Details

NPI number 1467426221
LBN Legal business name Moore, Jack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Jun 16th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467426221 NPPES
District of Columbia MEDICAID 025615700
District of Columbia MEDICAID 042931700
District of Columbia MEDICAID 5817889

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