Healthcare Provider Details

I. General information

NPI: 1518370105
Provider Name (Legal Business Name): AARON JOHN LESHIKAR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BRABHAM AVE
JACKSONVILLE NC
28546-5003
US

IV. Provider business mailing address

1000 BRABHAM AVE
JACKSONVILLE NC
28546-5003
US

V. Phone/Fax

Practice location:
  • Phone: 910-341-3495
  • Fax: 910-254-1263
Mailing address:
  • Phone: 910-341-3495
  • Fax: 910-254-1263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number652
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number652
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number652
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: