Individual
DR. KEITH ALDEN MOSHER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21 MERIDIAN SPRINGS DR, JACKSON, TN 38301
(731) 256-0526
(731) 256-1720
Mailing address
21 MERIDIAN SPRINGS DR, JACKSON, TN 38301-5900
(731) 256-0526
(731) 256-1720
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
24751
TN
207Q00000X
Family Medicine Physician
Primary
24751
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3078643
—
TN
Enumeration date
01/26/2007
Last updated
08/08/2018
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