Timothy Richard Moore
Interventional Cardiology Internist - Cardiovascular Disease
3025 W Cherry Lane Ste 205
Meridian
, Idaho 83642-8531
Timothy Richard Moore
Interventional Cardiology Internist - Cardiovascular Disease
3025 W Cherry Lane Ste 205
Meridian
, Idaho 83642-8531
(208) 367-8456
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About
Features
Specialties
- Internist - Cardiovascular Disease
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- Timothy Richard Moore
- 3340 E Goldstone Way
- Meridian, ID
- Zip : 83642-1026
- Fax : (208) 367-8456
- Phone : (208) 367-8484
Second Address
- Timothy Richard Moore
- 3025 W Cherry Lane Ste 205
- Meridian, ID
- Zip : 83642-8531
- Fax : (208) 367-8456
- Phone : (208) 367-8484
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0000X | Internist - Cardiovascular Disease | M-12911 | ID |
| N | 207RC0000X | Internist - Cardiovascular Disease | M0189 | TX |
| Y | 207RI0011X | Interventional Cardiology | M-12911 | ID |
National Provider Identifier
| NPI | 1124064423 |
|---|---|
| Provider Name | Timothy Richard Moore |
| First Address | Meridian, ID 83642-1026 |
| Second Address | Meridian, ID 83642-8531 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2006 |
| Last Update Date | 04/06/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.