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Individual
JOHN LEWIS LEAKE
Active
Individual
JOHN LEWIS LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14199280-1206
UT
363AS0400X
Surgical Physician Assistant
PA19359
TX
Other
Enumeration date
08/10/2023
Last updated
04/20/2026
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