Provider Demographics
NPI:1982835203
Name:THOMAS P. MOORE, M.D., PH.D., PC
Entity Type:Organization
Organization Name:THOMAS P. MOORE, M.D., PH.D., PC
Other - Org Name:MOORE ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:970-927-3344
Mailing Address - Street 1:100 ELK RUN DR STE 229
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-9244
Mailing Address - Country:US
Mailing Address - Phone:970-927-3714
Mailing Address - Fax:970-927-9555
Practice Address - Street 1:2001 N HORSESHOE TRL
Practice Address - Street 2:
Practice Address - City:SILT
Practice Address - State:CO
Practice Address - Zip Code:81652-9832
Practice Address - Country:US
Practice Address - Phone:970-927-3344
Practice Address - Fax:970-927-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4801080003Medicare NSC