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NPI Code Detail

MEDICARE: KURT A MOEHLE PH.D., H.S.P.P.

MEDICARE:   KURT A MOEHLE  PH.D., H.S.P.P.
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
1103TC0700XClinical Psychologist20040055AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2260032589OTHERINRAILROAD PROVIDER NUMBER

General Provider Information

NPI Number : 1720129505
Entity Type Code : Individual
Provider Name (Legal Business Name) : KURT A MOEHLE PH.D., H.S.P.P.
Provider Business Mailing Address
First Line : 1629 W 79TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-5232
Country : US
Telephone Number : 317-450-1942
Fax Number :
Provider Business Practice Location Address
First Line : 9002 N MERIDIAN ST
Second Line : STE 200
City : INDIANAPOLIS
State : IN
Zip : 46260-5350
Country : US
Telephone Number : 317-450-1942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 02/19/2018

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Directions to “ KURT A MOEHLE PH.D., H.S.P.P.” Practice Location

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