Individual
MR. JEFFREY A LEINICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1675 LEAHY ST, STE 324B, MUSKEGON, MI 49442-5500
(231) 725-5075
(231) 722-1827
Mailing address
1675 LEAHY ST, STE 324B, MUSKEGON, MI 49442-5500
(231) 725-5075
(231) 722-1827
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301041596
MI
207RG0100X
Gastroenterology Physician
MD60095455
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F17616001
MEDICARE ID
MI
05
—
2803023
—
MI
Enumeration date
10/31/2005
Last updated
09/09/2011
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