Moore, Randy Lee

Moore, Randy Lee is an individual health care provider with primary practice located at 2880 Nw Stewart Pkwy Ste 100 , Roseburg OR 97471-1201. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Moore, Randy Lee can be contacted via phone (541) 673-2267.

Contact Information

Primary practice address
2880 Nw Stewart Pkwy Ste 100 Roseburg OR 97471-1201
Phone: (541) 673-2267
Fax: (541) 672-9483
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X 28947 Colorado
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X DO26902 Oregon

Profile Details

NPI number 1508813817
LBN Legal business name Moore, Randy Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Nov 29th, 2021 - about 5 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 1508813817 NPPES
Oregon MEDICAID 026535
Oregon Other 016146005
Oregon MEDICAID 16753
Oregon Other P00332817

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