Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Timothy D Moore, DO

Individual provider Emergency Medicine Physician · NPI 1396762910

Timothy D Moore, DO is a Family Practice in O Fallon, Missouri. Qualified in 1993, 33 years ago. Practices with Physician Groups Lc, a 524-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
33
Licensed in
MO
In the registry since
2006
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

2630 Highway K
O Fallon, MO 63368-6624
Phone: (636) 240-5454
Fax: (636) 980-5335
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 106405 (MO)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 106405 (MO)

Record details

NPI number1396762910
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 17, 2006
Last updated in NPPESFebruary 15, 2021
Certification dateFebruary 15, 2021
Mailing address2630 Highway K, O Fallon, MO 63368-6624

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Physician Groups Lc — 524 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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