MEDICARE: JAMES L. MOSES, M.D., INC.

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
1	207W00000X	Ophthalmology Physician	35037237	OH

General Provider Information

NPI Number	:	1386747178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES L. MOSES, M.D., INC.

Provider Business Mailing Address
First Line	:	6441 WINCHESTER BLVD
Second Line	:	SUITE E
City	:	CANAL WNCHSTR
State	:	OH
Zip	:	43110-2033
Country	:	US
Telephone Number	:	614-834-1296
Fax Number	:	614-834-1339

Provider Business Practice Location Address
First Line	:	2680 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-3332
Country	:	US
Telephone Number	:	614-274-2020
Fax Number	:	614-272-8059

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JAMES LLOYD MOSES
Credential	:	M.D.
Telephone Number	:	614-834-1296

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	05/12/2008

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