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Individual

JEFFREY PARK LEAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
851 S RAMPART BLVD, SUTIE 220, LAS VEGAS, NV 89145-4882
(702) 947-7907
(702) 947-7907
Mailing address
851 S RAMPART BLVD, SUTIE 220, LAS VEGAS, NV 89145-4882
(702) 947-7907
(702) 947-7907

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00023374
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011311
WA
Enumeration date
12/13/2006
Last updated
08/12/2015
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