Healthcare Provider Details

I. General information

NPI: 1740985217
Provider Name (Legal Business Name): LEONARD MARK ROSEFIGURA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 LAKE OTIS PKWY STE 220
ANCHORAGE AK
99508-5230
US

IV. Provider business mailing address

4100 LAKE OTIS PKWY STE 220
ANCHORAGE AK
99508-5230
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-3145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number255184
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: