| |
1165 Walmart Way, Radcliff, KY 40160-1471 | |
(270) 351-3937 | |
(270) 352-2756 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 1165 Walmart Way, Radcliff, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629515630 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1206DT (Kentucky) | Primary |
Provider Name | David K Moore |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1871590596 PECOS PAC ID: 1254312697 Enrollment ID: I20040601000335 |
Mailing Address | Practice Location Address |
---|---|
1165 Walmart Way, Radcliff, KY 40160-1471 Ph: (270) 351-3937 | 1165 Walmart Way, Radcliff, KY 40160-1471 Ph: (270) 351-3937 |
Dr. John D. Roberts, Od Psc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 472 W Lincoln Trail Blvd, Radcliff, KY 40160 Phone: 270-351-8661 Fax: 270-351-8713 | |
David Moore, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 1165 Walmart Way, Radcliff, KY 40160 Phone: 270-351-3937 Fax: 270-352-2756 |