Basic Information
| Provider Information | |||||||||
| NPI: | 1750376356 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JARRETT | ||||||||
| FirstName: | LEKESHIA | ||||||||
| MiddleName: | WILLIAMS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 E PONCE DE LEON AVE | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300303466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043773436 | ||||||||
| FaxNumber: | 4043710019 | ||||||||
| Practice Location | |||||||||
| Address1: | 1333 S DICKINSON DR UNIT 140 | ||||||||
| Address2: | |||||||||
| City: | LELAND | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284516434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103413300 | ||||||||
| FaxNumber: | 9102512067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2005 | ||||||||
| LastUpdateDate: | 02/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2018-00318 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.