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General NPI Number Information
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NPI Number | 1346701422
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Entity Type | Individual
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Provider Name | JACOB DAMIEN LEGER MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 2750 ASTER ST.
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City | LAKE CHARLES
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State | LA
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Zip | 70601
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Country | US
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Telephone | 337-480-8900
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Fax | 337-480-8901
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Provider Business Mailing Address
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Address Line | PO BOX 122539 DEPT 2539
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City | DALLAS
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State | TX
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Zip | 75312-0001
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Country | US
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Telephone | 337-494-2921
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Fax | 337-494-6523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 323520
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License Number State | LA
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