Provider Demographics
NPI:1598268930
Name:MOXLEY, VICTOR BERT ARTHUR (JD, MPH, CPH)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:BERT ARTHUR
Last Name:MOXLEY
Suffix:
Gender:M
Credentials:JD, MPH, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 N 300 E
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-3001
Mailing Address - Country:US
Mailing Address - Phone:801-960-2192
Mailing Address - Fax:
Practice Address - Street 1:290 N 300 E
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-3001
Practice Address - Country:US
Practice Address - Phone:801-960-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
No173000000XOther Service ProvidersLegal Medicine
No1744R1102XOther Service ProvidersSpecialistResearch Study
No172V00000XOther Service ProvidersCommunity Health Worker