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General NPI Number Information
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NPI Number | 1104753664
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Entity Type | Individual
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Provider Name | MR. TIMOTHY HOWARD MOSELEY JR.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 1 BOSTON MEDICAL CTR PL STE 1
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City | BOSTON
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State | MA
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Zip | 02118-2999
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Country | US
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Telephone | 617-638-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1938 DUKER AVE
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City | LOUISVILLE
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State | KY
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Zip | 40205-1002
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Country | US
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Telephone | 502-345-2661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1167650
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License Number State | KY
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