Individual
LISA L LEEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 268-8000
Mailing address
PO BOX 22505, JACKSON, MS 39225-2505
(866) 321-8433
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
15897
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119543
—
MS
Enumeration date
09/07/2005
Last updated
07/08/2007
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