Provider Demographics
NPI:1801838826
Name:MOSES, CHRISTOPHER VINCENT (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:VINCENT
Last Name:MOSES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8222 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-1613
Mailing Address - Country:US
Mailing Address - Phone:918-493-3838
Mailing Address - Fax:918-493-1917
Practice Address - Street 1:8222 S. HARVARD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-1613
Practice Address - Country:US
Practice Address - Phone:918-493-3838
Practice Address - Fax:918-493-1917
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE15995Medicare UPIN