Individual provider · Type 1 NPI

Justin Moore, PHYSICIAN ASSISTANT

Medical Physician Assistant · Shreveport, LA

NPI number 1831743699 Active

Practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Call (870) 510-0171 Map

Mailing address

61 Weesner Ave Unit 3
Williamsburg, KY 40769-2051

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X346971 (LA)

Medical Physician Assistant: Definition to come...

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About NPI 1831743699

Justin Moore, PHYSICIAN ASSISTANT's National Provider Identifier is 1831743699, issued on Jul 30, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Shreveport, LA. The record was last updated on May 23, 2025.