Individual
JONATHAN BRENT MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
728 W 11TH AVE, COVINGTON, LA 70433-2318
(985) 892-3766
Mailing address
728 W 11TH AVE, COVINGTON, LA 70433-2318
(985) 892-3766
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
335264
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2017
Last updated
03/04/2026
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