Doctor Name: | RICHARD HAMPTON MOORE |
NPI Number: | 1326117433 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 539 |
Business Practice Address: | 4000 Highway 9 E # 235 Little River, SC - 295667833 |
Business Phone Number: | 8433901333 |
Business Fax Number: | |
Mailing Address: | 1700 26th Ave N, NORTH MYRTLE BEACH |
State: | SC |
Postal Code: | 295826110 |
Phone Number: | 8434504599 |
Fax Number: | |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 11/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 539 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |