Gregory L Moore Jr., PA-C
Physician Assistant in Ashland, KY. Individual provider (NPI-1).
NPI number1679889166
StatusActive
Last updated in NPPESAug 23, 2010
Details
- NPI
- 1679889166
- Entity type
- Individual (NPI-1)
- Name
- Gregory L Moore Jr.
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 23, 2010
- Last updated
- Aug 23, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
2301 Lexington AveSuite 230
Ashland, KY 41101-2873
Phone 606-326-1675 · Fax 606-326-1436
Mailing address
Po Box 1237Ashland, KY 41105-1237
Phone 606-326-1675 · Fax 606-326-1436
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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