Healthcare Provider Details

I. General information

NPI: 1083318109
Provider Name (Legal Business Name): TIMOTHY JAMES HOE-YAN MOY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 PLAZA DR STE 201
SIKESTON MO
63801-5148
US

IV. Provider business mailing address

1008 N MAIN ST
SIKESTON MO
63801-5044
US

V. Phone/Fax

Practice location:
  • Phone: 573-481-2210
  • Fax: 573-481-2220
Mailing address:
  • Phone: 573-472-7423
  • Fax: 573-472-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2023008998
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: