Rundall T Mosley
Individual provider Active NPI Driver · Springfield, MO
NPI 1659928554 · NPPES record last updated Aug 25, 2019
Key facts
- NPI
- 1659928554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 3850 W Edgewood St
Springfield, MO 65807-5584 - Phone
- (417) 824-5652
- NPI assigned
- Aug 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | Yes |
Addresses
Primary practice location
3850 W Edgewood St
Springfield, MO 65807-5584
Mailing address
3850 W Edgewood St
Springfield, MO 65807-5584
Phone (417) 824-5652
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.