Provider Demographics
NPI:1609570431
Name:MOORE, ALICIA PARIS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:PARIS
Last Name:MOORE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 RODGERS DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7434
Mailing Address - Country:US
Mailing Address - Phone:501-278-3100
Mailing Address - Fax:
Practice Address - Street 1:415 RODGERS DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7434
Practice Address - Country:US
Practice Address - Phone:501-278-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant