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Individual

DR. LARRY ALAN MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3205 N ACADEMY BLVD, SUITE 160, COLORADO SPRINGS, CO 80917-5101
(719) 776-3216
(719) 776-3187
Mailing address
290 CRYSTAL PARK ROAD, MANITOA SPRINGS, CO 80829
(719) 651-6070
(719) 686-8863

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21039
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42677076
CO
Enumeration date
05/08/2006
Last updated
08/20/2013
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