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:
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Health care specialties

SpecialtyCodeLicense #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 6 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 1548218381 NPPES
Oklahoma MEDICAID 20083990A
Oklahoma MEDICAID 158197001

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