Francis Bernard Moore, P.A.

Individual provider Active NPI Physician Assistant · Springerville, AZ

NPI 1235218850 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1235218850
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
2093 (AZ)
Practice address
118 S Mountain Ave
Springerville, AZ 85938-5104
Phone
(928) 333-4368
Fax
(928) 333-4369
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2093AZMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2093 AZ Yes

Addresses

Primary practice location

118 S Mountain Ave
Springerville, AZ 85938-5104

Mailing address

118 S Mountain Ave
Springerville, AZ 85938-5104
Phone (928) 333-4368

Other identifiers

IdentifierTypeStateIssuer
442517MedicaidAZ

Other providers in Springerville, AZ

All providers in Springerville, AZ · Physician Assistant in Arizona

Sources for this page

Verify at the official NPI Registry.