Provider Demographics
NPI:1912030271
Name:DR. JOHN D. MOSIER, PA
Entity Type:Organization
Organization Name:DR. JOHN D. MOSIER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:785-366-6457
Mailing Address - Street 1:6 NORTH BROADWAY
Mailing Address - Street 2:P.O. BOX # 425
Mailing Address - City:HERINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67449
Mailing Address - Country:US
Mailing Address - Phone:785-366-6457
Mailing Address - Fax:
Practice Address - Street 1:6 N BROADWAY
Practice Address - Street 2:
Practice Address - City:HERINGTON
Practice Address - State:KS
Practice Address - Zip Code:67449-2402
Practice Address - Country:US
Practice Address - Phone:785-366-6457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0525866207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100300090AMedicaid
KSCD8614OtherRAILROAD MEDICARE