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Individual
CLAIBORNE LAKE MOSELEY III
Active
Individual
CLAIBORNE LAKE MOSELEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N8222
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121550001
—
AR
Enumeration date
09/29/2005
Last updated
04/05/2017
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