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General NPI Number Information
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NPI Number | 1285648659
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Entity Type | Individual
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Provider Name | LUCIUS CLAYTON ANDREWS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 12000 HIGHWAY 57
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City | VANCLEAVE
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State | MS
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Zip | 39565-8235
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Country | US
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Telephone | 228-205-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 316 DEMONTLUZIN AVE
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City | BAY SAINT LOUIS
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State | MS
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Zip | 39520-4408
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Country | US
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Telephone | 504-258-4286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 15623
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 15191
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License Number State | MS
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