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Contact Information

MARK E MOSS, MD
3215 N NORTHHILLS BLVD
FAYETTEVILLE, AR72703-4424
 Phone: 479-463-7102
 Fax: 479-463-7864
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for MARK E MOSS · (Male)

NPI Number 1548218381
Status Active
Credentials MD
Entity Individual
Enumeration date 05/04/2006
Last updated 06/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • AR License # E-3803
  • AR Medicaid 158197001
  • OK Medicaid 20083990A
Hospital affiliation(s)
  • MERCY MEDICAL CENTER - (Acute Care)
    2710 RIFE MEDICAL LANE
    ROGERS, AR 72758
  • WASHINGTON REGIONAL MED CTR AT NORTH HILLS - (Acute Care)
    3215 N NORTH HILLS BLVD
    FAYETTEVILLE, AR 72703
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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