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NPI Code Detail

MEDICARE: THOMAS WAYNE MOXLEY M.D.

MEDICARE: THOMAS WAYNE MOXLEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianG53252CA

General Provider Information

NPI Number : 1033110184
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS WAYNE MOXLEY M.D.
Provider Business Mailing Address
First Line : 14500 LAS PALMAS DR
Second Line : UNIT #17
City : BAKERSFIELD
State : CA
Zip : 93306-9541
Country : US
Telephone Number : 610-806-2959
Fax Number :
Provider Business Practice Location Address
First Line : 1700 MOUNT VERNON AVE
Second Line : KERN MEDICAL CENTER
City : BAKERSFIELD
State : CA
Zip : 93306-4018
Country : US
Telephone Number : 661-326-2236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 06/20/2013

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