Provider Demographics
NPI:1952371767
Name:MOORE, RICHARD A II (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:MOORE
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8717 W 110TH ST STE 600
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2126
Mailing Address - Country:US
Mailing Address - Phone:913-428-2900
Mailing Address - Fax:913-428-2951
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1136
Practice Address - Country:US
Practice Address - Phone:816-276-4139
Practice Address - Fax:816-276-3109
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2018-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS05-37058207L00000X
MO2000164187207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H53326Medicare UPIN