Jacobs, Leslie

Jacobs, Leslie is an individual health care provider with primary practice located at 1509 Atkinson Rd Suite 1100, Lawrenceville GA 30043-7986. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Jacobs, Leslie can be contacted via phone (770) 995-2379.

Contact Information

Primary practice address
1509 Atkinson Rd Suite 1100 Lawrenceville GA 30043-7986
Phone: (770) 995-2379
Fax: (770) 995-2385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X OT001219 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT001219 Georgia

Profile Details

NPI number 1770644684
LBN Legal business name Jacobs, Leslie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Oct 27th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770644684 NPPES
Georgia MEDICAID 000726778A
Georgia MEDICAID 10037750
Georgia MEDICAID 306075

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