Individual
KEVIN E MOCKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 LOCK LANE., # 14, LAKE CHARLES, LA 70605
(337) 494-2445
(337) 430-6979
Mailing address
4000 LOCK LANE., # 14, LAKE CHARLES, LA 70605
(337) 494-2445
(337) 430-6979
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L014771
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320072
—
LA
Enumeration date
11/05/2006
Last updated
09/09/2010
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