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General NPI Number Information
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NPI Number | 1992772248
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Entity Type | Individual
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Provider Name | ERIC JON LESCAULT DO
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Gender | Male
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 902 N HOWE ST
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City | SOUTHPORT
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State | NC
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Zip | 28461-3038
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Country | US
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Telephone | 910-457-4789
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Fax | 910-457-5824
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Provider Business Mailing Address
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Address Line | 2716 ASHTON DR
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City | WILMINGTON
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State | NC
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Zip | 28412-2489
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Country | US
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Telephone | 910-332-3800
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Fax | 910-251-0421
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | H54427
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2006-00977
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License Number State | NC
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