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NPI Code Detail

MEDICARE: PEYTON MOORE

MEDICARE:   PEYTON  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
1104100000XSocial WorkerLSW.0009927301CO

General Provider Information

NPI Number : 1750218970
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEYTON MOORE
Provider Business Mailing Address
First Line : 26539 PLEASANT PARK RD
Second Line :
City : CONIFER
State : CO
Zip : 80433-7765
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26539 PLEASANT PARK RD APT 104
Second Line :
City : CONIFER
State : CO
Zip : 80433-7765
Country : US
Telephone Number : 417-434-2917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “ PEYTON MOORE ” Practice Location

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