Individual
JORGE LEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5952 LAKE TIDE COVE, MEMPHIS, TN 38120-4121
(901) 683-9704
Mailing address
5952 LAKE TIDE COVE, MEMPHIS, TN 38120-4121
(901) 683-9704
(662) 893-6729
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD0000025752
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115189
—
MS
05
—
3092808
—
TN
Enumeration date
07/31/2006
Last updated
08/04/2008
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