Provider Demographics
NPI:1760488522
Name:MOSELEY, JOHN INNIS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:INNIS
Last Name:MOSELEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:315 N 15TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-2534
Mailing Address - Country:US
Mailing Address - Phone:406-237-4050
Mailing Address - Fax:406-237-4004
Practice Address - Street 1:315 N 15TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-2534
Practice Address - Country:US
Practice Address - Phone:406-237-4050
Practice Address - Fax:406-237-4004
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT7468174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist