Provider Demographics
NPI:1528264157
Name:MOORE, LOUIS THOMAS III (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:THOMAS
Last Name:MOORE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 QUEEN ST APT 2111
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5168
Mailing Address - Country:US
Mailing Address - Phone:949-433-4838
Mailing Address - Fax:
Practice Address - Street 1:1380 LUSITANA ST STE 512
Practice Address - Street 2:PHYSICIAN'S OFFICE BUILDING
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2441
Practice Address - Country:US
Practice Address - Phone:808-748-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01066214A2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology