Provider Demographics
NPI:1992742811
Name:WASCOME, ERIC JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSEPH
Last Name:WASCOME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 HENNESSY BLVD
Mailing Address - Street 2:HOSPITAL MEDICINE SERVICE
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4375
Mailing Address - Country:US
Mailing Address - Phone:225-765-4050
Mailing Address - Fax:225-765-4046
Practice Address - Street 1:5000 HENNESSY BLVD
Practice Address - Street 2:HOSPITAL MEDICINE SERVICE
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4375
Practice Address - Country:US
Practice Address - Phone:225-765-4050
Practice Address - Fax:225-765-4046
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA026668208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02127360Medicaid
LAP00330910OtherRAIL ROAD MEDICARE
LA1059528Medicaid
MS02127360Medicaid
LAP00330910OtherRAIL ROAD MEDICARE