Individual
DR. PATRICK TIMOTHY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
(720) 321-0000
(720) 321-1621
Mailing address
PO BOX 223897, PITTSBURGH, PA 15251-2897
(720) 501-5000
(303) 458-3997
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25922
CO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
DR.0025922
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01259225
—
CO
01
—
P00262610
RAILROAD MEDICARE
CO
Enumeration date
03/17/2006
Last updated
11/08/2019
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