MEDICARE: JOHN SYLVAIN LEIPSIC JR. 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
1	2084P0804X	Child & Adolescent Psychiatry Physician	45399	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	45399	OTHER	AZ	LICENSE
3	1859330	OTHER	CA	EDS PIN

General Provider Information

NPI Number	:	1841281060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SYLVAIN LEIPSIC JR. M.D.

Provider Business Mailing Address
First Line	:	3501 E SPEEDWAY BLVD STE 351
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3917
Country	:	US
Telephone Number	:	888-374-5066
Fax Number	:	719-623-0165

Provider Business Practice Location Address
First Line	:	3501 E SPEEDWAY BLVD STE 351
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3917
Country	:	US
Telephone Number	:	888-374-5066
Fax Number	:	719-623-0165

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	12/03/2025

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