Provider Demographics
NPI:1487668208
Name:MOORE, FRANK NORMAN (OD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:NORMAN
Last Name:MOORE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:8004 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3644
Mailing Address - Country:US
Mailing Address - Phone:918-461-2367
Mailing Address - Fax:918-461-8717
Practice Address - Street 1:8004 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3644
Practice Address - Country:US
Practice Address - Phone:918-461-2367
Practice Address - Fax:918-461-8717
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1138152W00000X
CO1333152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100767650AMedicaid
T89068Medicare UPIN