Individual provider · Type 1 NPI

John Wayne Moore, PA-C

Medical Physician Assistant · Wasilla, AK

NPI number 1669552550 Active

Practice location

1001 E Bogard Rd
Wasilla, AK 99654-7114

Fax (907) 376-9225

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XNone listed
Medical Physician Assistant Primary 363AM0700X508 (AK)

Medical Physician Assistant: Definition to come...

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About NPI 1669552550

John Wayne Moore, PA-C's National Provider Identifier is 1669552550, issued on Oct 16, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Wasilla, AK. The record was last updated on Jul 1, 2024.