Individual
CLAIBORNE LAKE MOSELEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 CARSON ST, JONESBORO, AR 72401-3104
(870) 935-0519
(870) 802-0355
Mailing address
300 CARSON ST, JONESBORO, AR 72401-3104
(870) 935-0519
(870) 802-0355
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N8222
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121550001
—
AR
Enumeration date
09/29/2005
Last updated
04/05/2017
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