Provider Demographics
NPI:1538598453
Name:CHRISTOPHER R. MOOR, M.D., P.C.
Entity type:Organization
Organization Name:CHRISTOPHER R. MOOR, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-726-1122
Mailing Address - Street 1:1881 W. 24TH STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6298
Mailing Address - Country:US
Mailing Address - Phone:928-726-1122
Mailing Address - Fax:928-726-7955
Practice Address - Street 1:1881 W. 24TH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6298
Practice Address - Country:US
Practice Address - Phone:928-726-1122
Practice Address - Fax:928-726-7955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTOPHER R. MOOR, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15872207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ1099Medicare UPIN