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Individual

JACOB LEEDEKERKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-1200
Mailing address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
238485
NC

Other

Enumeration date
03/30/2018
Last updated
04/10/2025
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