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NPI Code Detail

MEDICARE: JULIAN ROBERT MOSS DO

MEDICARE: JULIAN ROBERT MOSS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician13918042-1204UT
22084P0800XPsychiatry PhysicianR-12160IA
32084P0804XChild & Adolescent Psychiatry Physician13918042-1204UT

General Provider Information

NPI Number : 1124696943
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIAN ROBERT MOSS DO
Provider Business Mailing Address
First Line : 501 S CHIPETA WAY RM 1000
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1222
Country : US
Telephone Number : 801-581-2121
Fax Number :
Provider Business Practice Location Address
First Line : 501 S CHIPETA WAY RM 1000
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1222
Country : US
Telephone Number : 801-581-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2021
Last Update Date : 05/20/2026

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