Individual
MR. JEFFREY H LACOURSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
201 E GROVER ST, SHELBY, NC 28150-3917
(980) 487-3678
(980) 487-3294
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(980) 487-3678
(980) 487-3294
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2006-01936
NC
207R00000X
Internal Medicine Physician
215918
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578565032
—
NC
05
—
5905709
—
NC
05
—
N01936
—
SC
Enumeration date
08/15/2005
Last updated
01/23/2015
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