Healthcare Provider Details

I. General information

NPI: 1922110386
Provider Name (Legal Business Name): DONALD G MOSELEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 GREAT CIRCLE RD
NASHVILLE TN
37228-1404
US

IV. Provider business mailing address

208 MANLEY CT
FRANKLIN TN
37069-6214
US

V. Phone/Fax

Practice location:
  • Phone: 615-565-4089
  • Fax: 615-565-4092
Mailing address:
  • Phone: 615-972-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number334
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: