Healthcare Provider Details

I. General information

NPI: 1598268930
Provider Name (Legal Business Name): VICTOR BERT ARTHUR MOXLEY JD, MPH, CPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 N 300 E
PROVO UT
84606-3001
US

IV. Provider business mailing address

290 N 300 E
PROVO UT
84606-3001
US

V. Phone/Fax

Practice location:
  • Phone: 801-960-2192
  • Fax:
Mailing address:
  • Phone: 801-960-2192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: