Liebsack, Joseph P

Liebsack, Joseph P is an individual health care provider with primary practice located at 758 Old Norcross Rd Suite 100, Lawrenceville GA 30046-3385. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Liebsack, Joseph P can be contacted via phone (770) 962-4300.

Contact Information

Primary practice address
758 Old Norcross Rd Suite 100 Lawrenceville GA 30046-3385
Phone: (770) 962-4300
Fax: (770) 339-7544
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002143 Georgia

Profile Details

NPI number 1528048196
LBN Legal business name Liebsack, Joseph P
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Sep 16th, 2009 - about 17 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 1528048196 NPPES
Georgia MEDICAID 100002498D

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