Individual
KYLE MOSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 469-6610
(260) 969-3065
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001771A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300008567
—
IN
Enumeration date
10/23/2014
Last updated
07/11/2025
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