Individual
JESSICA THORNER LEUCHTENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-3819
Mailing address
940 BELMONT ST, BROCKTON, MA 02301-5596
(617) 584-0471
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
1025066
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1025066
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
3015691
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2021
Last updated
06/01/2026
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