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NPI Code Detail

MEDICARE: ELIZABETH MOSELEY OD

MEDICARE: ELIZABETH MOSELEY OD
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
1152W00000XOptometrist2132AZ

General Provider Information

NPI Number : 1902258734
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MOSELEY OD
Provider Business Mailing Address
First Line : 220 N MCKEMY AVE
Second Line :
City : CHANDLER
State : AZ
Zip : 85226-2654
Country : US
Telephone Number : 480-961-1865
Fax Number : 480-893-8172
Provider Business Practice Location Address
First Line : 3788 S 16TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85713-6079
Country : US
Telephone Number : 520-388-9741
Fax Number : 520-388-9750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2016
Last Update Date : 07/19/2023

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Directions to “ ELIZABETH MOSELEY OD” Practice Location

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