MEDICARE: JOSEPH LAWRENCE MASS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	014416	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780651042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH LAWRENCE MASS M.D.

Provider Business Mailing Address
First Line	:	303 VETERANS BLVD
Second Line	:	SUITE A
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4722
Country	:	US
Telephone Number	:	225-665-7785
Fax Number	:	225-664-4623

Provider Business Practice Location Address
First Line	:	303 VETERANS BLVD
Second Line	:	SUITE A
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4722
Country	:	US
Telephone Number	:	225-665-7785
Fax Number	:	225-664-4623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	05/06/2010

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