person
Mark S Moore, DO
Diagnostic Radiology Physician in Pueblo, Colorado
NPI 1457465429

Mark S Moore is a Diagnostic Radiology Physician based in Loveland, CO and is specialized in Diagnostic Radiology. Mark S Moore practices in Pueblo, CO and has the professional credentials of DO. The NPI Number for Mark S Moore is 1457465429 and holds a License No. 112240 (Colorado).

The current practice location address for Mark S Moore is 1008 Minnequa Ave, Pueblo, CO and can be reached out via phone at 719-557-4000 and via fax at 970-342-2093.

Location: 1008 Minnequa Ave, Pueblo, CO, 80537-0693
person
Provider Profile Details
NPI Number
1457465429
Provider Name
Mark S Moore
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1008 Minnequa Ave, Pueblo, CO, 80537-0693
Phone Number
719-557-4000
Fax Number
970-342-2093
Provider Enumeration Date
08/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100180650B 01 OK CAID
100343220A 01 KS CAID
83787844 05 CO
451258 01 HLTLINK
115634 01 MO BLUE
112240 01 MO MEDICAL LICENSE
248699902 05 MO
institution
Provider Business Practice Location Address Details
Address
1008 Minnequa Ave
City
State
Zip
81004-3733
Phone Number
719-557-4000
Fax Number
970-342-2093
person
Provider Business Mailing Address Details
Address
1008 Minnequa Ave
City
State
Zip
81004-3733
Phone Number
719-557-4000
Fax Number
970-342-2093
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
112240 (Missouri)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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