MARK S MOORE DO NPI 1457465429

NPI Information

  • NPI: 1457465429
  • Provider Name: MARK S MOORE, DO
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1008 MINNEQUA AVE
    PUEBLO, CO
    ZIP 81004
  • Phone: (719) 557-4000

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NPI Details

Mark S Moore, DO is a diagnostic radiology radiology in Pueblo, CO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Mark S Moore, DO NPI is 1457465429. 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:

1008 MINNEQUA AVE
PUEBLO, CO
ZIP 81004-733
Phone: (719) 557-4000
Fax: (970) 342-2093

The NPI 1457465429 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 11/5/2020.

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
12085R0202XRadiologyDiagnostic Radiology112240MISSOURIYes

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
1100180650BOTHEROK CAID
2112240OTHERMISSOURIMEDICAL LICENSE
383787844MEDICAIDCOLORADO
4451258OTHERHLTLINK
5100343220AOTHERKS CAID
6115634OTHERMO BLUE
7248699902MEDICAIDMISSOURI

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: 11/21/2025

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