Scott Randall Moore in Hurlburt Field - Physician Assistant
Scott Randall Moore - NPI 1174613053
Scott Randall Moore is a Physician Assistant in Hurlburt Field, Florida. Scott Randall Moore practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Scott Randall Moore is 1174613053. The last update date is 2022-06-09.
Scott Randall Moore's current location address is 113 Lielmanis Ave, Hurlburt Field, Florida. You can contact this provider via phone number 8508811020. The mailing address for Scott Randall Moore is 113 Lielmanis Ave, Hurlburt Field, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Scott Randall Moore |
|---|---|
| Address | 113 Lielmanis Ave, Hurlburt Field, Florida |
| Phone Number | 8508811020 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1174613053 |
|---|---|
| Provider Enumeration Date | 2006-10-13 |
| Last Updated Date | 2022-06-09 |
Provider Mailing Address Detail
| Address | 113 Lielmanis Ave |
|---|---|
| City | Hurlburt Field |
| State | Florida (FL) |
| Post Code | 325445613 |
| Phone Number | 8508811020 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA01382 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the Scott Randall Moore's unique identification number?
The Scott Randall Moore has been assigned the NPI (National Provider Identifier) Number 1174613053 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Scott Randall Moore's physical address?
The Scott Randall Moore is physically located at 113 Lielmanis Ave, in the city of Hurlburt Field, FL, with the postal code 325445613.
What is the Scott Randall Moore's area of specialization and corresponding taxonomy classification?
The Scott Randall Moore's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
When did the Scott Randall Moore receive its 1174613053?
The Scott Randall Moore was issued its 1174613053 on 2006-10-13, which is the date when the organization was assigned this unique identifier.
As of what date were the details related to Scott Randall Moore most recently updated or revised?
The information pertaining to Scott Randall Moore, including its address, specialty, and other relevant details, was last updated or revised on 2022-06-09.
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