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NPI Code Detail

MEDICARE: JOHN MOORE

MEDICARE: JOHN MOORE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1154269207
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MOORE
Provider Business Mailing Address
First Line : 601 E HAMPDEN AVE STE 470
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80113-2797
Country : US
Telephone Number : 303-788-3150
Fax Number :
Provider Business Practice Location Address
First Line : 601 E HAMPDEN AVE STE 470
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80113-2797
Country : US
Telephone Number : 303-788-3150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ JOHN MOORE ” Practice Location

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