Provider Demographics
NPI:1427419613
Name:MOORE SURGICAL ARTS & GYNECOLOGY, PLLC
Entity Type:Organization
Organization Name:MOORE SURGICAL ARTS & GYNECOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PITTMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-995-5010
Mailing Address - Street 1:5018 CLUB RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4750
Mailing Address - Country:US
Mailing Address - Phone:870-995-5010
Mailing Address - Fax:855-386-7000
Practice Address - Street 1:5018 CLUB RD STE 101
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4750
Practice Address - Country:US
Practice Address - Phone:870-995-5010
Practice Address - Fax:855-386-7000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty