Individual
NATHAN THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
140 N LITCHFIELD RD STE 110, GOODYEAR, AZ 85338-1226
(602) 256-2525
(602) 256-0795
Mailing address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1266
(623) 537-5600
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
006433
AZ
207X00000X
Orthopaedic Surgery Physician
006433
AZ
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
006433
AZ
208600000X
Surgery Physician
006433
AZ
390200000X
Student in an Organized Health Care Education/Training Program
58.003264
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916205
—
AZ
Enumeration date
10/14/2009
Last updated
10/31/2024
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