Forrest Moudy, is a
Dentist - General Practice based in Danville, Arkansas. Forrest Moudy is licensed to practice in Arkansas (license number 2030) and his current practice location is
105 E 10th St, Danville, Arkansas. He can be reached at his office (for appointments etc.) via phone at
(479) 495-2115.
NPI number for Forrest Moudy is 1750707097 and his current mailing address is Po Box 878, Danville, Arkansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1750707097.
Healthcare Provider's Profile
| Full Name | Forrest Moudy |
|---|
| Gender | Male |
|---|
| Speciality | Dentist - General Practice |
|---|
| Location | 105 E 10th St, Danville, Arkansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1750707097
- Provider Enumeration Date: 03/11/2014
- Last Update Date: 03/11/2014
Medical Identifiers
Medical identifiers for Forrest Moudy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750707097 | NPI | - | NPPES |
| 106597608 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 2030 (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Forrest Moudy is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Forrest Moudy,
Po Box 878,
Danville, AR 72833-0878
Ph: (479) 495-2115 | Forrest Moudy,
105 E 10th St,
Danville, AR 72833-0878
Ph: (479) 495-2115 |
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