Moss, Douglas

Moss, Douglas is an individual health care provider with primary practice located at 814 Northwood Park Dr , Valdosta GA 31602-1398. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Moss, Douglas can be contacted via phone (229) 259-0032.

Contact Information

Primary practice address
814 Northwood Park Dr Valdosta GA 31602-1398
Phone: (229) 259-0032
Fax: (229) 259-0068
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 41178 Georgia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME58453 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 1870621 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 041178 Georgia

Profile Details

NPI number 1679542781
LBN Legal business name Moss, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jun 21st, 2010 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1679542781 NPPES
Georgia MEDICAID 000687574K
Georgia Other 110177668
Georgia Other 525985740

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