| Doctor Name: | DR. TIMOTHY L MOORE |
| NPI Number: | 1518939792 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 2469 |
| Business Practice Address: | 3212 Sw 89th St Suite 100 Oklahoma City, OK - 731597956 |
| Business Phone Number: | 4053783300 |
| Business Fax Number: | 4053783993 |
| Mailing Address: | 3212 Sw 89th St, Suite 100 OKLAHOMA CITY |
| State: | OK |
| Postal Code: | 731597956 |
| Phone Number: | 4053783300 |
| Fax Number: | 4053783993 |
| NPI Enumeration Date: | 02/02/2006 |
| NPI Last Update Date: | 07/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2469 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |