1669650990 NPI number — MOSES & MOUSER, M.D.'S, INC.

Table of content: (NPI 1669650990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669650990 NPI number — MOSES & MOUSER, M.D.'S, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOSES & MOUSER, M.D.'S, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JAMES L. MOSES, MD'S, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669650990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6441 WINCHESTER BLVD
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
CANAL WINCHESTER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43110-2033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-834-1296
Provider Business Mailing Address Fax Number:
614-834-1339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2680 W BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43204-3332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-274-2020
Provider Business Practice Location Address Fax Number:
614-272-8059
Provider Enumeration Date:
02/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MOSES
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
LLOYD
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
614-834-1296

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2877767 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2493190 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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