Individual
JAY EDWARD MOSCOE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 N MAIN ST, MADISON, VA 22727-3035
(540) 948-6861
Mailing address
PO BOX 587, MADISON, VA 22727-0587
(540) 948-6861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101028982
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067495
ANTHEM/BC/BS
—
05
—
5644399
—
VA
Enumeration date
04/18/2006
Last updated
07/08/2007
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