Individual
DR. ANTHONY K ADEOSUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 DOCTOR MICHAEL DEBAKEY DR, SUITE 120, LAKE CHARLES, LA 70601-5887
(337) 493-8480
(337) 493-8482
Mailing address
333 DOCTOR MICHAEL DEBAKEY DR, SUITE120, LAKE CHARLES, LA 70601-5887
(337) 433-4077
(337) 433-5598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14928
MS
207Q00000X
Family Medicine Physician
Primary
MD202004
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117499
—
MS
05
—
1638820
—
LA
Enumeration date
08/28/2006
Last updated
07/28/2015
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