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NPI Code Detail

MEDICARE: DR. KENNETH WAYNE MOSS M.D.

MEDICARE:  DR. KENNETH WAYNE MOSS  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
12084N0400XNeurology Physician0036402NC

General Provider Information

NPI Number : 1447241781
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH WAYNE MOSS M.D.
Provider Business Mailing Address
First Line : 1901 VETERANS MEMORIAL DRIVE, NEUROLOGY SECTION
Second Line : CENTRAL TEXAS VETERANS HEALTH CARE SYSTEM
City : TEMPLE
State : TX
Zip : 76504-7451
Country : US
Telephone Number : 254-721-6105
Fax Number : 254-743-0132
Provider Business Practice Location Address
First Line : 1901 VETERANS MEMORIAL DRIVE, NEUROLOGY SECTION
Second Line : CENTRAL TEXAS VETERANS HEALTH CARE SYSTEM
City : TEMPLE
State : TX
Zip : 76504-7451
Country : US
Telephone Number : 254-721-6105
Fax Number : 254-743-0132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 04/03/2008

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Directions to “ DR. KENNETH WAYNE MOSS M.D.” Practice Location

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