Provider Demographics
NPI:1194192732
Name:JOBSON, LEAH MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:MARIE
Last Name:JOBSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:WADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:1624 MARS HILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-4813
Mailing Address - Country:US
Mailing Address - Phone:706-310-1030
Mailing Address - Fax:
Practice Address - Street 1:1624 MARS HILL RD STE B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677
Practice Address - Country:US
Practice Address - Phone:706-310-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8780207R00000X, 363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine