Moose, Scott R.
Moose, Scott R. is an individual health care provider with primary practice located at 940 W Mount Vernon St , Nixa MO 65714-9609. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Moose, Scott R. can be contacted via phone (417) 724-5200.Contact Information
Primary practice address
940 W Mount Vernon St
Nixa MO 65714-9609
Phone: (417) 724-5200
Fax: (417) 724-5203
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 113804 | Missouri |
Profile Details
| NPI number | 1255405023 |
|---|---|
| LBN Legal business name | Moose, Scott R. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | May 9th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255405023 | NPPES |
| Missouri | MEDICAID | 209747302 |
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