Healthcare Provider Details

I. General information

NPI: 1982665287
Provider Name (Legal Business Name): JOHN DAVID MOSIER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 NORTH BROADWAY
HERINGTON KS
67449
US

IV. Provider business mailing address

PO BOX 425
HERINGTON KS
67449-0425
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 Number05-25866
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: