Individual
MARCIA MONROE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4140 W MEMORIAL RD, STE 408, OKLAHOMA CITY, OK 73120-8300
(580) 436-3980
(580) 421-6205
Mailing address
1 MERCADO ST STE 220, DURANGO, CO 81301-7310
(970) 764-3450
(970) 382-6607
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2003031471
MO
208600000X
Surgery Physician
28726
OK
208600000X
Surgery Physician
Primary
DR.0067559
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206304701
—
MO
01
—
P00390780
RAILROAD MEDICARE
MO
Enumeration date
11/15/2006
Last updated
10/22/2021
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