DR. MICHAEL KIRK MOORE M.D. P.C. NPI 1306064860

NPI Information

NPI: 1306064860
Provider Name: DR. MICHAEL KIRK MOORE, M.D., P.C.
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

Address:
2860 CHANNING WAY
SUITE 213
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 552-1406
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DR. Michael Kirk Moore, M.D., P.C. is a plastic and reconstructive surgery surgery in Idaho Falls, ID. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Michael Kirk Moore, M.D., P.C. NPI is 1306064860. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2860 CHANNING WAY
SUITE 213
IDAHO FALLS, ID
ZIP 83404-531
Phone: (208) 552-1406
Fax: (208) 552-1416

The enumeration date for this NPI number is 4/23/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery	M-8270	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CS9201	OTHER	IDAHO	ID ST BOARD OF PHARMACY
2	BM4151849	OTHER	IDAHO	DEA
3	F95588	MEDICARE UPIN	IDAHO
4	5959620-1205	OTHER	UTAH	UT MEDICAL LICENSE
5	M-8270	OTHER	IDAHO	MEDICAL LICENSE, ID
6	5959620-8905	OTHER	UTAH	UT ST BOARD OF PHARMACY
7	1101834	MEDICARE ID-TYPE UNSPECIFIED	IDAHO
8	58MKM02	OTHER	WYOMING	WY ST BOARD OF PHARMACY
9	6687A	OTHER	WYOMING	WY MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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