Doctor Name: | NATHAN D LENOX |
NPI Number: | 1245440676 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., D.M.D. |
License Number: | S-476 |
Business Practice Address: | 3716 Gilbert Dr Shreveport, LA - 711045004 |
Business Phone Number: | 3182101889 |
Business Fax Number: | |
Mailing Address: | 3716 Gilbert Dr, SHREVEPORT |
State: | LA |
Postal Code: | 711045004 |
Phone Number: | 3182101889 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 02/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | S-476 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |