Dr Leroy Justice, DDS is a
Dentist - General Practice based in Sparta, Georgia. Dr Leroy Justice is licensed to practice in Georgia (license number 8775) and his current practice location is
12900 Broad St, Sparta, Georgia. He can be reached at his office (for appointments etc.) via phone at
(706) 444-6886.
NPI number for Dr Leroy Justice is 1619185576 and his current mailing address is 12900 Broad St, Sparta, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619185576.
Healthcare Provider's Profile
| Full Name | Dr Leroy Justice |
|---|
| Gender | Male |
|---|
| Speciality | Dentist - General Practice |
|---|
| Location | 12900 Broad St, Sparta, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1619185576
- Provider Enumeration Date: 05/21/2007
- Last Update Date: 07/12/2007
Medical Identifiers
Medical identifiers for Dr Leroy Justice such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619185576 | NPI | - | NPPES |
| 00254493A | Medicaid | GA | |
| 00254943B | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 8775 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Leroy Justice is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Leroy Justice, DDS
12900 Broad St,
Sparta, GA 31087-1737
Ph: (706) 444-6886 | Dr Leroy Justice, DDS
12900 Broad St,
Sparta, GA 31087-1737
Ph: (706) 444-6886 |
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