Individual
DR. CLEMENT EMERY LACOSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 N MAIN ST, CHARLTON, MA 01507-1590
(508) 248-6780
(508) 248-8134
Mailing address
105 COUNTRY CLUB PL, SOUTHBRIDGE, MA 01550
(508) 764-6026
(508) 764-7866
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26014
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2087863
—
MA
Enumeration date
08/11/2006
Last updated
08/23/2012
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