Provider Demographics
NPI:1134129489
Name:MOORE, NEAL O (DO)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:O
Last Name:MOORE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:2700 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3251
Mailing Address - Country:US
Mailing Address - Phone:816-691-5289
Mailing Address - Fax:816-346-7690
Practice Address - Street 1:8800 NW 112TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1104
Practice Address - Country:US
Practice Address - Phone:816-464-2333
Practice Address - Fax:816-464-5272
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2015-10-22
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Provider Licenses
StateLicense IDTaxonomies
MO108896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA5756001Medicare PIN
MOE09841Medicare UPIN