Individual
DR. GAYLAN WAYNE MOUSHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0460088755
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K51088
MEDICARE PTAN
IL
Enumeration date
02/23/2007
Last updated
05/21/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us