Provider Demographics
NPI:1730209289
Name:FLOWERS, SETHELLE LUCAS (MD)
Entity type:Individual
Prefix:DR
First Name:SETHELLE
Middle Name:LUCAS
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 HIGHWAY 51
Mailing Address - Street 2:SUITE F1
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-3424
Mailing Address - Country:US
Mailing Address - Phone:601-853-2440
Mailing Address - Fax:601-853-2460
Practice Address - Street 1:299 HIGHWAY 51
Practice Address - Street 2:SUITE F1
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-3424
Practice Address - Country:US
Practice Address - Phone:601-853-2440
Practice Address - Fax:601-853-2460
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10767207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS070000018Medicare ID - Type Unspecified
MSA99753Medicare UPIN