Healthcare Provider Details

I. General information

NPI: 1912030271
Provider Name (Legal Business Name): DR. JOHN D. MOSIER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 N BROADWAY
HERINGTON KS
67449-2402
US

IV. Provider business mailing address

6 NORTH BROADWAY P.O. BOX # 425
HERINGTON KS
67449
US

V. Phone/Fax

Practice location:
  • Phone: 785-366-6457
  • Fax:
Mailing address:
  • Phone: 785-258-6028
  • Fax: 785-645-5006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0525866
License Number StateKS

VIII. Authorized Official

Name: DR. JOHN D MOSIER
Title or Position: CEO-PRESIDENT
Credential: D.O.
Phone: 785-258-6028