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

Timothy Richard Moore, MD

Individual provider Interventional Cardiology Physician · NPI 1124064423

Timothy Richard Moore, MD is an Interventional Cardiology Physician in Boise, Idaho. Licensed in Idaho and Texas. Registered with an NPI since 2006.

Licensed in
ID, TX
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

500 W Fort St #111
Boise, ID 83702
Phone: (208) 422-1000
Fax: (208) 422-1319
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Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence M-12911 (ID)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence M-12911 (ID)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence M0189 (TX)

Record details

NPI number1124064423
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 22, 2006
Last updated in NPPESFebruary 15, 2022
Certification dateFebruary 15, 2022
Mailing address500 W Fort St # 111, Boise, ID 83702-4501

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