Individual
DR. GRANT HARRIS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
(602) 508-4830
Mailing address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
(602) 598-4830
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
55263
AZ
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
55263
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349369
—
AZ
Enumeration date
10/14/2012
Last updated
05/01/2019
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