Provider Demographics
NPI:1215315569
Name:MOORE, KATHRYN PAX LATTIMORE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:PAX LATTIMORE
Last Name:MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2910
Mailing Address - Country:US
Mailing Address - Phone:919-330-0546
Mailing Address - Fax:
Practice Address - Street 1:UF HEALTH CENTER FOR MOVEMENT DISORDER AND RESTORATION
Practice Address - Street 2:3450 HULL RD
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-294-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1403402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology