Individual provider · NPI-1

Dr. Anthony K Adeosun, M.D.

Family Medicine · Lake Charles, LA

NPI number1568570653
StatusActive
Last updated in NPPESJul 28, 2015

Details

NPI
1568570653
Entity type
Individual (NPI-1)
Name
Dr. Anthony K Adeosun
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 28, 2006
Last updated
Jul 28, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineMD202004LAYes
207Q00000X Family Medicine14928MS

Practice location

333 Doctor Michael Debakey Dr
Suite 120
Lake Charles, LA 70601-5887

Phone 337-493-8480 · Fax 337-493-8482

Mailing address

333 Doctor Michael Debakey Dr
Suite120
Lake Charles, LA 70601-5887

Phone 337-433-4077 · Fax 337-433-5598

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