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JONATHAN R MORAN DO
>> Emergency Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1902244734
Individual Registrant: JONATHAN R MORAN DO
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
23500 US HIGHWAY 160 WALSENBURG, CO 81089-9524 US
Tel: 719-735-5100 Fax: --
Tel: 719-735-5100 Fax: --
Contact information for business:
23500 US HIGHWAY 160 WALSENBURG, CO 81089-9524 US
Tel: 719-738-5100 Fax: 719-738-5138
Tel: 719-738-5100 Fax: 719-738-5138
Registration Information:
NPI: 1902244734
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207P00000X | Allopathic & Osteopathic Physicians Emergency Medicine | CO | DR.0058359 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
