Individual
DAVID F MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
802 LIZABETH DR, JOHNSON CITY, TN 37604-1949
(423) 283-0733
Mailing address
802 LIZABETH DR, JOHNSON CITY, TN 37604-1949
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20674
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3052491
—
TN
Enumeration date
06/15/2005
Last updated
05/27/2025
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