| Dr. Angela Moss | |
|
126 Jmz Dr Gordonsville TN 38563-2152 | |
| (615) 683-1070 | |
| (615) 683-1079 |
| Full Name | Dr. Angela Moss |
|---|---|
| Speciality | Family Medicine |
| Location | 126 Jmz Dr, Gordonsville, Tennessee |
| Authorized Official Name and Position | Angela S Moss (OWNER) |
| Authorized Official Contact | 6156831070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Angela Moss 126 Jmz Dr Gordonsville TN 38563-2152 Ph: (615) 683-1070 | Dr. Angela Moss 126 Jmz Dr Gordonsville TN 38563-2152 Ph: (615) 683-1070 |
| NPI Number | 1033310206 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 02/03/2010 |
| Medicare PECOS PAC ID | 7719916691 |
|---|---|
| Medicare Enrollment ID | O20050810001248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033310206 | NPI | - | NPPES |
| 3874872 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35031 (Tennessee) | Primary |
| Provider Name | Angela S Moss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457428195 PECOS PAC ID: 0749217388 Enrollment ID: I20050725001254 |
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