Basic Information
| Provider Information | |||||||||
| NPI: | 1043272107 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOSS | ||||||||
| FirstName: | HENRY | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 192 RICE RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283286425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007716106 | ||||||||
| FaxNumber: | 9108227970 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 RAMSEY ST | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283013856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007716106 | ||||||||
| FaxNumber: | 9108227970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 95-01021 | NC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.