Individual
JEFFREY L.EONARD JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1310 E 7TH ST STE F, AUBURN, IN 46706-2518
(260) 266-8900
(260) 266-8935
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01036727A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020027041
MEDICARE RAILROAD
IN
05
—
0999728
—
OH
05
—
100081240
—
IN
05
—
103410325
—
MI
Enumeration date
08/04/2005
Last updated
10/03/2022
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