Provider Demographics
NPI:1629063839
Name:MOOR, CHRISTOPHER R (PC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:MOOR
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1881 W 24TH ST
Mailing Address - Street 2:STE. B
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6297
Mailing Address - Country:US
Mailing Address - Phone:928-726-1122
Mailing Address - Fax:928-726-7955
Practice Address - Street 1:1881 W 24TH ST
Practice Address - Street 2:STE. B
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6297
Practice Address - Country:US
Practice Address - Phone:928-726-1122
Practice Address - Fax:928-726-7955
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ15872207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ253716OtherSTATE AHCCCS
AZ2114K872OtherSTATE FUND OF AZ
AZAZ0818590OtherBLUECROSS/ BLUESHIELD
AZ0400423OtherUNITED HEALTHCARE
AZD37329Medicare UPIN
AZ110159327Medicare ID - Type UnspecifiedRAILROAD MEDICARE
AZZ21099Medicare PIN