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NPI Code Detail

MEDICARE: DAVID ALLEN MOORE MD

MEDICARE: DAVID ALLEN MOORE MD
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
1207Q00000XFamily Medicine PhysicianC174268CA
2207Q00000XFamily Medicine Physician57025AZ

General Provider Information

NPI Number : 1841559846
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ALLEN MOORE MD
Provider Business Mailing Address
First Line : 2614 N 20TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85009-1937
Country : US
Telephone Number : 928-210-6053
Fax Number :
Provider Business Practice Location Address
First Line : 444 W OSBORN RD STE 200
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3817
Country : US
Telephone Number : 480-410-6121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2012
Last Update Date : 10/10/2023

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Directions to “ DAVID ALLEN MOORE MD” Practice Location

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