Provider Demographics
NPI:1740439199
Name:MOORE, KRISTI A (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:A
Last Name:MOORE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 THE LEGENDS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025
Mailing Address - Country:US
Mailing Address - Phone:636-549-0121
Mailing Address - Fax:636-549-0122
Practice Address - Street 1:20 THE LEGENDS PARKWAY
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025
Practice Address - Country:US
Practice Address - Phone:636-549-0121
Practice Address - Fax:636-549-0122
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008016709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine