Provider Demographics
NPI:1598721565
Name:MOORE, ALAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:L
Last Name:MOORE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4283
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36803-4283
Mailing Address - Country:US
Mailing Address - Phone:334-528-1112
Mailing Address - Fax:334-528-1547
Practice Address - Street 1:2000 PEPPERELL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5452
Practice Address - Country:US
Practice Address - Phone:334-528-1112
Practice Address - Fax:334-528-1547
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL15874207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-79266OtherBLUE CROSS OF AL PROV #
AL510-79266OtherBLUE CROSS OF AL PROV #
ALF60008Medicare UPIN