Provider Demographics
NPI:1598710915
Name:MOSES, LUFKIN R (DO)
Entity Type:Individual
Prefix:DR
First Name:LUFKIN
Middle Name:R
Last Name:MOSES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:200 E ARIZONA
Mailing Address - Street 2:#5
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79566-7120
Mailing Address - Country:US
Mailing Address - Phone:325-235-3800
Mailing Address - Fax:325-235-3313
Practice Address - Street 1:200 E ARIZONA
Practice Address - Street 2:#5
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79566-7120
Practice Address - Country:US
Practice Address - Phone:325-235-3800
Practice Address - Fax:325-235-3313
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE6855207P00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD97578Medicare UPIN
TX00145HMedicare PIN