MEDICARE: STEVEN JAMES LEIGHTON

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	152W00000X	Optometrist	1443	NC

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

General Provider Information

NPI Number	:	1982607412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN JAMES LEIGHTON

Provider Business Mailing Address
First Line	:	7148 LAWYERS RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-3906
Country	:	US
Telephone Number	:	704-535-9252
Fax Number	:	704-535-6634

Provider Business Practice Location Address
First Line	:	7148 LAWYERS RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-3906
Country	:	US
Telephone Number	:	704-535-9252
Fax Number	:	704-535-6634

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	10/16/2014

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