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General NPI Number Information
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NPI Number | 1720708753
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Entity Type | Organization
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Legal Business Name | MOORE ADVANCED ORTHOPEDICS PLLC
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 140 N LITCHFIELD RD STE 110
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City | GOODYEAR
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State | AZ
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Zip | 85338-1226
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Country | US
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Telephone | 707-980-4454
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Fax |
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Provider Business Mailing Address
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Address Line | 9426 W SADDLEHORN RD
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City | PEORIA
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State | AZ
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Zip | 85383-1523
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Country | US
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Telephone | 707-980-4454
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN MOORE
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Credential | DO
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Telephone | 707-980-4454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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