DR. JACK ELLIS MOSELEY M.D. NPI 1558438887

NPI Information

  • NPI: 1558438887
  • Provider Name: DR. JACK ELLIS MOSELEY, M.D.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2600 E WILLOW RD
    NORTHERN OKLAHOMA RESOURCE CENTER
    ENID, OK
    ZIP 73701
  • Phone: (580) 213-2700

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NPI Details

DR. Jack Ellis Moseley, M.D. is an internal medicine in Enid, OK. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DR. Jack Ellis Moseley, M.D. NPI is 1558438887. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2600 E WILLOW RD
NORTHERN OKLAHOMA RESOURCE CENTER
ENID, OK
ZIP 73701-715
Phone: (580) 213-2700
Fax: (580) 548-2647

The NPI 1558438887 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 8/26/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics20477OKLAHOMANo
2207R00000XInternal Medicine20477OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G90142MEDICARE UPINIOWA
2G90142MEDICARE UPINOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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