Organization
MOSS STREET MEDICAL CLINIC INC
Active
Organization
MOSS STREET MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKIE EDWARD JOHNSON PA (OWNER)
(337) 232-3371
Entity
Organization
Contact information
Practice address
1417 MOSS ST, LAFAYETTE, LA 70501-3654
(337) 232-3371
(337) 232-3511
Mailing address
1417 MOSS ST, LAFAYETTE, LA 70501-3654
(337) 232-3371
(337) 232-3511
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A10226
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448397
—
LA
Enumeration date
03/02/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up