Provider Demographics
NPI:1306872171
Name:LETONOFF, ERIC JUDE (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JUDE
Last Name:LETONOFF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2101 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-5340
Mailing Address - Country:US
Mailing Address - Phone:228-497-7576
Mailing Address - Fax:228-497-8869
Practice Address - Street 1:15190 COMMUNITY RD STE 120
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3484
Practice Address - Country:US
Practice Address - Phone:228-205-6825
Practice Address - Fax:228-831-8782
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2024-02-20
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Provider Licenses
StateLicense IDTaxonomies
MS18468207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery