Dr. Melinda Beth Moore, DPM
Podiatrist, Foot & Ankle Surgery in Carterville, IL. Individual provider (NPI-1).
NPI number1508003849
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1508003849
- Entity type
- Individual (NPI-1)
- Name
- Dr. Melinda Beth Moore
- Credential
- DPM
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 8, 2009
- Last updated
- Mar 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | 016005343 | IL | Yes |
Practice location
807 S Division StCarterville, IL 62918-1528
Phone 618-985-3338 · Fax 618-985-3338
Mailing address
807 S Division StCarterville, IL 62918-1528
Phone 618-985-3338 · Fax 618-985-3339
Other practice locations
3022 S Park Ave
Herrin, IL 62948-3721
Herrin, IL 62948-3721
Phone 847-302-8115 · Fax 618-942-3336
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