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Contact Information

RANDY L MOORE, DO
2880 NW STEWART PKWY STE 100
ROSEBURG, OR97471-1201
 Phone: 541-673-2267
 Fax: 541-672-9483
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
 

Radiation Oncology

2085R0203X
Indicates primary specialty

NPI Profile & details for RANDY L MOORE · (Male)

NPI Number 1508813817
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/30/2006
Last updated 11/29/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 28947
  • OR License # DO26902
  • ND Medicaid 16753
  • OR Medicaid 026535
  • OR Other 016146005 BCBS
  • OR Other P00332817 RAILROAD MEDICARE
Hospital affiliation(s)
  • MERCY MEDICAL CENTER - (Acute Care)
    2700 NW STEWART PARKWAY
    ROSEBURG, OR 97471
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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