# C.V. MOSES, D.O. INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHSIDE MEDICAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710139076
- **Authorized official:** CHRISTOPER VINCENT MOSES D.O. (PHYSICIAN)
- **Authorized official phone:** (918) 493-3838

## Contact information

- **Practice address:** 8222 S. HARVARD AVE, TULSA, OK 74136-1613
- **Practice address phone:** (918) 493-3838
- **Mailing address:** 8222 S. HARVARD AVE, TULSA, OK 74136-1613
- **Mailing address phone:** (918) 493-3838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2008
- **Last updated:** 11/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100023050A | — | OK |