Individual
NATHANIEL RAY MOXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10425 W NORTH AVE STE 140, WAUWATOSA, WI 53226-2400
(414) 877-6414
Mailing address
10425 W NORTH AVE STE 140, WAUWATOSA, WI 53226-2400
(414) 877-6414
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
86817-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/29/2017
Last updated
01/25/2026
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