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NPI Code Detail

MEDICARE: DR. GEORGE DENNIS LEAKS OD

MEDICARE: DR. GEORGE DENNIS LEAKS OD
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
1152W00000XOptometristOD224NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2NV2986OTHERNVBCBS

General Provider Information

NPI Number : 1942296868
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE DENNIS LEAKS OD
Provider Business Mailing Address
First Line : 2120 E CALVADA BLVD
Second Line :
City : PAHRUMP
State : NV
Zip : 89048-5805
Country : US
Telephone Number : 775-727-8300
Fax Number : 775-727-1221
Provider Business Practice Location Address
First Line : 2120 E CALVADA BLVD
Second Line :
City : PAHRUMP
State : NV
Zip : 89048-5805
Country : US
Telephone Number : 775-727-8300
Fax Number : 775-727-1221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 03/13/2008

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Directions to “ DR. GEORGE DENNIS LEAKS OD” Practice Location

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