Healthcare Provider Details

I. General information

NPI: 1376471573
Provider Name (Legal Business Name): LEON SIPES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 E WILLIAMS FIELD RD APT 2070
GILBERT AZ
85295-0824
US

IV. Provider business mailing address

2505 E WILLIAMS FIELD RD APT 2070
GILBERT AZ
85295-0824
US

V. Phone/Fax

Practice location:
  • Phone: 928-333-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number80634077
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: