Provider Demographics
NPI:1740773993
Name:MOSIER, LINCOLN MARCUS (DO)
Entity Type:Individual
Prefix:DR
First Name:LINCOLN
Middle Name:MARCUS
Last Name:MOSIER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:557 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:OR
Mailing Address - Zip Code:97720-1441
Mailing Address - Country:US
Mailing Address - Phone:541-573-7281
Mailing Address - Fax:541-573-8627
Practice Address - Street 1:559 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:OR
Practice Address - Zip Code:97720-1441
Practice Address - Country:US
Practice Address - Phone:541-573-2074
Practice Address - Fax:541-573-8627
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WY144-T2207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY144-T1OtherSTATE OF WYOMING BOARD OF MEDICINE