Moss, Mark E
Moss, Mark E is an individual health care provider with primary practice located at 3215 N Northhills Blvd , Fayetteville AR 72703-4424. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Moss, Mark E can be contacted via phone (479) 463-7102.Contact Information
Primary practice address
3215 N Northhills Blvd
Fayetteville AR 72703-4424
Phone: (479) 463-7102
Fax: (479) 463-7864
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | E-3803 | Arkansas |
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | E-3803 | Arkansas |
Profile Details
NPI number | 1548218381 |
---|---|
LBN Legal business name | Moss, Mark E |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 4th, 2006 |
Last updated | Jun 21st, 2019 - about 5 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 | 1548218381 | NPPES |
Oklahoma | MEDICAID | 20083990A | |
Oklahoma | MEDICAID | 158197001 |
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