Individual
LESTER COX MOREHEAD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HIGHWAY, LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER, SHREVEPORT, LA 71104-0000
(318) 675-5621
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-7636
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
203154
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1887218
—
LA
01
—
4M130F600
MEDICARE - PTAN
LA
Enumeration date
01/12/2009
Last updated
03/02/2012
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