Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Kathleen Moore, DO

Individual provider Emergency Medical Services (Emergency Medicine) Physician · NPI 1902837776

Mary Kathleen Moore, DO is an Emergency Medicine in Tahlequah, Oklahoma. Graduated from Oklahoma State University College of Osteopathic Medicine in 2001, 25 years ago. Practices with Northeastern Health System, a 104-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
25
Trained at
Oklahoma State University College of Osteopathic Medicine
Licensed in
OK
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone: (918) 458-3104
Fax: (918) 458-3580
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medical Services (Emergency Medicine) Physician (primary) Taxonomy 207PE0004X · Licence 3976 (OK)

Record details

NPI number1902837776
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedJuly 6, 2006
Last updated in NPPESJuly 8, 2007
Mailing addressPo Box 675, Tahlequah, OK 74465-0675

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2001 (25 years in practice)
Group practice Northeastern Health System — 104 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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