Individual
KENTON K MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1519 S PHILLIPS ST, ALGONA, IA 50511
(515) 295-7714
(515) 295-4505
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 494-3041
(641) 494-3059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21583
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0202721
—
IA
01
—
20272
WELLMARK
IA
Enumeration date
08/12/2006
Last updated
07/08/2020
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