Individual
GREGORY D LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 W FERTITTA BLVD STE 1, LEESVILLE, LA 71446-4665
(337) 238-0167
(337) 238-0574
Mailing address
301 W FERTITTA BLVD STE 1, LEESVILLE, LA 71446-4665
(337) 238-0167
(337) 238-0574
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
016350
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1322750
—
LA
Enumeration date
08/29/2005
Last updated
07/08/2007
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