Organization
W.O. MOSS REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD R SMITHBURG (VICE CHANCELLOR CEO)
(225) 922-1474
Entity
Organization
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 475-8100
(337) 415-8104
Mailing address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 475-8100
(337) 415-8104
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1449415
—
LA
Enumeration date
03/02/2007
Last updated
08/22/2020
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