Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35.089151 | OH |
N | 207X00000X | Orthopaedic Surgeon | 53991 | TN |
N | 207XS0106X | Orthopaedic Hand Surgeon | 35.089151 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 53991 | TN |
NPI | 1265655385 |
---|---|
Provider Name | Joshua Parker Moss |
First Address | Knoxville, TN 37920 |
Second Address | Knoxville, TN 37920-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 23/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q021837 | (05) | TN |