Individual
JONATHAN ALAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9250 N 3RD ST STE 2030, PHOENIX, AZ 85020-2407
(602) 786-0200
Mailing address
9250 N 3RD ST STE 2030, PHOENIX, AZ 85020-2407
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
302603
NY
207RP1001X
Pulmonary Disease Physician
Primary
70643
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
10/27/2023
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