Provider Demographics
NPI:1730874405
Name:MOORE, ALEXANDER PATRICK (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:PATRICK
Last Name:MOORE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1056
Mailing Address - Street 2:
Mailing Address - City:WESTVIEW
Mailing Address - State:KY
Mailing Address - Zip Code:40178-1056
Mailing Address - Country:US
Mailing Address - Phone:270-617-2324
Mailing Address - Fax:
Practice Address - Street 1:1325 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3427
Practice Address - Country:US
Practice Address - Phone:270-651-4797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program