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Individual

JAMES LUNDY MOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
255 BERT KOUNS, SHREVEPORT, LA 71106
(318) 683-0411
(318) 603-5461
Mailing address
255 BERT KOUNS LOOP, SHREVEPORT, LA 71106-8150
(318) 683-0411
(318) 603-5461

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
013320
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1321737
LA
01
340012587
RAILROAD MEDICARE
LA
Enumeration date
06/20/2005
Last updated
03/24/2010
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