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General NPI Number Information
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NPI Number | 1679625628
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Entity Type | Organization
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Legal Business Name | DRS MOULTON & PARSONS MD
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 502 2ND AVE S
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City | ST JAMES
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State | MN
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Zip | 56081
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Country | US
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Telephone | 507-375-3141
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Fax |
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Provider Business Mailing Address
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Address Line | 502 2ND AVE S
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City | ST JAMES
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State | MN
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Zip | 56081
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Country | US
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Telephone | 507-375-3141
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MR. KEITH BUELL MOULTON
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Credential | MD
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Telephone | 507-375-3141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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