Provider Demographics
NPI:1295704377
Name:LASKEY, JAMES EDGAR (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDGAR
Last Name:LASKEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 BAYOU GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-1434
Mailing Address - Country:US
Mailing Address - Phone:985-868-7901
Mailing Address - Fax:985-868-2445
Practice Address - Street 1:335 BAYOU GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-1434
Practice Address - Country:US
Practice Address - Phone:985-868-7901
Practice Address - Fax:985-868-2445
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD062R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1384160Medicaid
T19695Medicare UPIN
LA1384160Medicaid