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General NPI Number Information
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NPI Number | 1942640875
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Entity Type | Individual
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Provider Name | JOSIAH MOULTON D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1005 N EASTMAN RD
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City | LONGVIEW
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State | TX
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Zip | 75601-4231
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Country | US
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Telephone | 903-247-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 N EASTMAN RD
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City | LONGVIEW
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State | TX
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Zip | 75601-4231
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Country | US
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Telephone | 903-247-8262
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11505690-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125.063892
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 1294
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T6652
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License Number State | TX
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