Healthcare Provider Details

I. General information

NPI: 1407350895
Provider Name (Legal Business Name): CHRISTOPHER ELMORE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 S PIERPONT DR
MESA AZ
85206-4697
US

IV. Provider business mailing address

3370 N HAYDEN RD STE 123-212
SCOTTSDALE AZ
85251-6632
US

V. Phone/Fax

Practice location:
  • Phone: 602-844-3200
  • Fax:
Mailing address:
  • Phone: 254-258-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD479409
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD479409
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: