Provider Demographics
NPI:1932118486
Name:MOORE, JOHN CORY (MD,)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CORY
Last Name:MOORE
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Gender:M
Credentials:MD,
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Mailing Address - Street 1:8401 W DODGE RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3451
Mailing Address - Country:US
Mailing Address - Phone:402-955-6877
Mailing Address - Fax:402-955-6880
Practice Address - Street 1:110 N 175TH ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3582
Practice Address - Country:US
Practice Address - Phone:402-955-5437
Practice Address - Fax:402-955-7310
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-01-22
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Provider Licenses
StateLicense IDTaxonomies
NE13117208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics