Provider Demographics
NPI:1598929507
Name:MOORE, RUBIN M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBIN
Middle Name:M
Last Name:MOORE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4500 COLLEGE BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1760
Mailing Address - Country:US
Mailing Address - Phone:913-338-0400
Mailing Address - Fax:913-338-0428
Practice Address - Street 1:4500 COLLEGE BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1760
Practice Address - Country:US
Practice Address - Phone:913-338-0400
Practice Address - Fax:913-338-0428
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2012-11-07
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Provider Licenses
StateLicense IDTaxonomies
MO20080182012084P0800X
KS04-356212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry