Mathew D Moore, D.C. Inc.
Organization Active NPI Chiropractor · Holbrook, AZ
NPI 1497939300 · NPPES record last updated Dec 27, 2007
Key facts
- NPI
- 1497939300
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5746AZ (AZ)
- Legal business name
- MATHEW D MOORE, D.C. INC.
- Practice address
- 322 W Hopi Dr
Holbrook, AZ 86025-2950 - Phone
- (928) 524-1900
- NPI assigned
- Dec 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Mathew David Moore, D.C.
- Title
- President
- Phone
- (928) 524-1900
Practitioners 1
-
Mathew David Moore, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050827000190 | AZ | Part B Supplier - Clinic/Group Practice | 7618908823 |
Receives reassigned benefits from 1 practitioner Practice locations: Holbrook, AZ |
National Provider Directory
Locations
322 W Hopi Dr
Holbrook, AZ 86025
Phone (928) 524-1900
165 W Hopi Dr
Holbrook, AZ 86025
Phone (928) 524-1896
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 5746AZ | AZ | Yes |
Addresses
Primary practice location
322 W Hopi Dr
Holbrook, AZ 86025-2950
Mailing address
322 W Hopi Dr
Holbrook, AZ 86025-2950
Phone (928) 524-1900
Other providers in Holbrook, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.