| David B Moore, Phd, Psc | |
|
3400 Stony Spring Circle Louisville KY 40220-5428 | |
| (502) 819-8300 | |
| (502) 499-4431 |
| Full Name | David B Moore, Phd, Psc |
|---|---|
| Speciality | Social Worker |
| Location | 3400 Stony Spring Circle, Louisville, Kentucky |
| Authorized Official Name and Position | David Bruce Moore (PRESIDENT) |
| Authorized Official Contact | 5028198300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David B Moore, Phd, Psc 3400 Stony Spring Cir Louisville KY 40220-5428 Ph: (502) 819-8300 | David B Moore, Phd, Psc 3400 Stony Spring Circle Louisville KY 40220-5428 Ph: (502) 819-8300 |
| NPI Number | 1265535231 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Medicare PECOS PAC ID | 1355368622 |
|---|---|
| Medicare Enrollment ID | O20051026000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265535231 | NPI | - | NPPES |
| 8290014300 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | David B Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760585798 PECOS PAC ID: 4981742566 Enrollment ID: I20101228000826 |
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