MEDICARE: DR. JAMES B MOSELEY MD

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	2084P0800X	Psychiatry Physician	E3549	AR
2	2084P0804X	Child & Adolescent Psychiatry Physician	MD13184	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568438505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES B MOSELEY MD

Provider Business Mailing Address
First Line	:	4646 POPLAR AVE
Second Line	:	SUITE 317
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4426
Country	:	US
Telephone Number	:	901-268-5707
Fax Number	:	901-374-0924

Provider Business Practice Location Address
First Line	:	4646 POPLAR AVE
Second Line	:	SUITE 317
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4426
Country	:	US
Telephone Number	:	901-268-5707
Fax Number	:	901-374-0924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	11/25/2013

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