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NPI Code Detail

MEDICARE: DR. PHILIP GEORGE LEONE M.D.

MEDICARE: DR. PHILIP GEORGE LEONE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist22769NC

General Provider Information

NPI Number : 1588664098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP GEORGE LEONE M.D.
Provider Business Mailing Address
First Line : PO BOX 3628
Second Line :
City : GASTONIA
State : NC
Zip : 28054-0020
Country : US
Telephone Number : 704-834-2851
Fax Number : 704-834-2815
Provider Business Practice Location Address
First Line : 2525 COURT DR
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2140
Country : US
Telephone Number : 704-834-2851
Fax Number : 704-834-2815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 12/03/2007

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