Moss, Jacob Wayne

Moss, Jacob Wayne is an individual health care provider with primary practice located at 283 N 1St St , Driggs ID 83422-5109. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Moss, Jacob Wayne can be contacted via phone (208) 354-2302.

Contact Information

Primary practice address
283 N 1St St Driggs ID 83422-5109
Phone: (208) 354-2302
Fax: (208) 354-8392
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X TM190 Georgia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X M-14547 Idaho

Profile Details

NPI number 1205179751
LBN Legal business name Moss, Jacob Wayne
Credentials M.D., J.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2013
Last updated Aug 22nd, 2022 - about 3 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.

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