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NPI Code Detail

MEDICARE: ALICIA LEEDY MD

MEDICARE:   ALICIA  LEEDY  MD
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
1208000000XPediatrics Physician01047074AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000319536OTHERINANTHEM

General Provider Information

NPI Number : 1902810831
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA LEEDY MD
Provider Business Mailing Address
First Line : 6626 E. 75TH STREET
Second Line : SUITE 500
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11911 N MERIDIAN ST
Second Line : SUITE 180
City : CARMEL
State : IN
Zip : 46032-6904
Country : US
Telephone Number : 317-621-6888
Fax Number : 317-621-6886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 11/27/2023

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Directions to “ ALICIA LEEDY MD” Practice Location

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