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NPI Code Detail

MEDICARE: JAMES B LEKAS PAC

MEDICARE:   JAMES B LEKAS  PAC
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
1363A00000XPhysician Assistant002431GA
2363AM0700XMedical Physician Assistant002431GA
3363AS0400XSurgical Physician Assistant002431GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00168001OTHERGARAILROAD MEDICARE
2DC4061OTHERGARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043205388
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES B LEKAS PAC
Provider Business Mailing Address
First Line : 2400 BELLEVUE RD
Second Line : SUITE 21-A
City : DUBLIN
State : GA
Zip : 31021-2885
Country : US
Telephone Number : 478-275-7202
Fax Number : 478-274-8418
Provider Business Practice Location Address
First Line : 1157 FORSYTH ST
Second Line :
City : MACON
State : GA
Zip : 31201-7452
Country : US
Telephone Number : 478-745-8581
Fax Number : 478-328-0438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 03/12/2015

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Directions to “ JAMES B LEKAS PAC” Practice Location

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