Individual
JONATHAN R MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
23500 US HIGHWAY 160, WALSENBURG, CO 81089-9524
(719) 735-5100
Mailing address
23500 US HIGHWAY 160, WALSENBURG, CO 81089-9524
(719) 738-5100
(719) 738-5138
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0058359
CO
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
DR.0058359
CO
Other
Enumeration date
06/14/2013
Last updated
04/26/2023
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