Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 9178 | TN |
Y | 1223G0001X | General Practice | 9178 | TN |
Y | 213EG0000X | General Practice | 9178 | TN |
NPI | 1588976641 |
---|---|
Provider Name | Jeffrey Scott Leech |
First Address | Murfreesboro, TN 37129-5155 |
Second Address | Murfreesboro, TN 37129-5155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 18/11/2010 |