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Stephen Lightell, LSA

Physician Assistant, Surgical in Mandeville, LA. Individual provider (NPI-1).

NPI number1871969873
StatusActive
Last updated in NPPESMay 4, 2018

Details

NPI
1871969873
Entity type
Individual (NPI-1)
Name
Stephen Lightell
Credential
LSA
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 13, 2015
Last updated
May 4, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, SurgicalSA0167DCYes
246ZC0007X Specialist/Technologist, Other, Surgical Assistant15-493WI

Practice location

1196 Springwater Dr
Mandeville, LA 70471-7434

Phone 504-442-6060

Mailing address

1196 Springwater Dr
Mandeville, LA 70471-7434

Phone 504-442-6060

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