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General NPI Number Information
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NPI Number | 1457396814
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Entity Type | Individual
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Provider Name | PHILIP MOYER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 1713 US HIGHWAY 441 N STE H
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City | OKEECHOBEE
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State | FL
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Zip | 34972-1900
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Country | US
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Telephone | 863-357-1510
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Fax | 863-357-1518
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Provider Business Mailing Address
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Address Line | 1713 US HIGHWAY 441 N STE H
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City | OKEECHOBEE
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State | FL
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Zip | 34972-1900
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Country | US
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Telephone | 863-357-1510
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Fax | 863-357-1518
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME 102679
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License Number State | FL
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