Provider Demographics
NPI:1386747178
Name:JAMES L. MOSES, M.D., INC.
Entity type:Organization
Organization Name:JAMES L. MOSES, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-834-1296
Mailing Address - Street 1:6441 WINCHESTER BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:CANAL WNCHSTR
Mailing Address - State:OH
Mailing Address - Zip Code:43110-2033
Mailing Address - Country:US
Mailing Address - Phone:614-834-1296
Mailing Address - Fax:614-834-1339
Practice Address - Street 1:2680 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3332
Practice Address - Country:US
Practice Address - Phone:614-274-2020
Practice Address - Fax:614-272-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037237207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1167340001Medicare NSC
OH9191664Medicare PIN