Individual
MR. ROBERT GENE MOULT
Active
Individual
MR. ROBERT GENE MOULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
3824
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100183610A
—
OK
01
—
300120729
RAILROAD MEDICARE
OK
01
—
300129663
RAILROAD MEDICARE
OK
Enumeration date
11/21/2005
Last updated
08/05/2024
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