Individual
DR. MARK ROBERT MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 E ROBINSON ST, NORMAN, OK 73071-6610
(405) 364-7900
(405) 366-6214
Mailing address
PO BOX 654354, DALLAS, TX 75265-4354
(405) 364-7900
(405) 366-6214
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
23214
OK
207X00000X
Orthopaedic Surgery Physician
Primary
23214
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195480001
PALMETTO
OK
05
—
200065700A
—
OK
01
—
7689494
AETNA
OK
01
—
P00049091
RR MEDICARE
OK
Enumeration date
07/13/2005
Last updated
04/11/2023
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