Provider Demographics
NPI:1083860233
Name:LEIBIG, JONATHAN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:SCOTT
Last Name:LEIBIG
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:7902 VALTOURMANCHE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6036
Mailing Address - Country:US
Mailing Address - Phone:501-343-9697
Mailing Address - Fax:
Practice Address - Street 1:10651 E ST BLDG 100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78419-5130
Practice Address - Country:US
Practice Address - Phone:361-961-3216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL298242083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine