Provider Demographics
NPI:1588995716
Name:MOSS, WILLIAM B (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:MOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 DAVIES MANOR DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-0977
Mailing Address - Country:US
Mailing Address - Phone:901-388-0321
Mailing Address - Fax:
Practice Address - Street 1:4010 DAVIES MANOR DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-0977
Practice Address - Country:US
Practice Address - Phone:901-388-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD4954207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND84295Medicare UPIN