Doctor Name: | DR. LUCIEN KENNEDY MOSS |
NPI Number: | 1255441382 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 015821 |
Business Practice Address: | 2770 3rd Ave Suite 120 Lake Charles, LA - 70601 |
Business Phone Number: | 3374944868 |
Business Fax Number: | 3374944870 |
Mailing Address: | 2770 3rd Ave, Suite 120 LAKE CHARLES |
State: | LA |
Postal Code: | 706018994 |
Phone Number: | 3374944868 |
Fax Number: | 3374944870 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 04/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 015821 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |