Healthcare Provider Details

I. General information

NPI: 1447213665
Provider Name (Legal Business Name): JAMES ARTHUR LESSARD PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USS ABRAHAM LINCOLN # 72
FPO AP
96612-2872
US

IV. Provider business mailing address

778 WINDBROOK CIR
NEWPORT NEWS VA
23602-8862
US

V. Phone/Fax

Practice location:
  • Phone: 757-817-3943
  • Fax:
Mailing address:
  • Phone: 757-272-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: