| Doctor Name: | DR. GEORGE GLENN LE-BERT |
| NPI Number: | 1033318928 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OS10063 |
| Business Practice Address: | 1340 S 18th St Ste 202 Credentialing Department Fernandina Beach, FL - 320344733 |
| Business Phone Number: | 9042619786 |
| Business Fax Number: | 9042616567 |
| Mailing Address: | Po Box 43667, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322033667 |
| Phone Number: | 9043983760 |
| Fax Number: | 9042616567 |
| NPI Enumeration Date: | 07/12/2007 |
| NPI Last Update Date: | 11/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207UN0901X |
| License Number: | OS10063 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Nuclear Medicine |
| Taxonomy Specialization: | Nuclear Cardiology |
| Taxonomy Definition: | A nuclear medicine physician who specializes in nuclear cardiology. |