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General NPI Number Information
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NPI Number | 1770524597
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Entity Type | Organization
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Legal Business Name | W O MOSS REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1000 WALTERS ST
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City | LAKE CHARLES
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State | LA
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Zip | 70607-4647
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Country | US
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Telephone | 337-475-8100
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Fax | 337-475-8104
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Provider Business Mailing Address
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Address Line | 1000 WALTERS ST
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City | LAKE CHARLES
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State | LA
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Zip | 70607-4647
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Country | US
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Telephone | 337-475-8100
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Fax | 337-475-8104
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Authorized Official
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Title or Position | VICE CHANCELLOR CEO
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Name | MR. DONALD R SMITHBURG
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Credential |
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Telephone | 225-922-1474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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