Provider Demographics
NPI:1003562372
Name:MOSHEIM RECOVERY ASSOCIATES
Entity Type:Organization
Organization Name:MOSHEIM RECOVERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-422-2126
Mailing Address - Street 1:65 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:MOSHEIM
Mailing Address - State:TN
Mailing Address - Zip Code:37818-3206
Mailing Address - Country:US
Mailing Address - Phone:423-422-2126
Mailing Address - Fax:
Practice Address - Street 1:65 PAYNE RD
Practice Address - Street 2:
Practice Address - City:MOSHEIM
Practice Address - State:TN
Practice Address - Zip Code:37818-3206
Practice Address - Country:US
Practice Address - Phone:423-422-2126
Practice Address - Fax:423-422-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty