Healthcare Provider Details

I. General information

NPI: 1376557371
Provider Name (Legal Business Name): MORNING STAR OBSTETRICS & GYNECOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3499 S MERCY RD
GILBERT AZ
85297-0437
US

IV. Provider business mailing address

3499 S MERCY RD
GILBERT AZ
85297-0437
US

V. Phone/Fax

Practice location:
  • Phone: 480-355-8525
  • Fax: 480-355-3115
Mailing address:
  • Phone: 480-355-8525
  • Fax: 480-355-3115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CLINTON JOSEPH LEONARD
Title or Position: PRESIDENT
Credential: MD
Phone: 480-355-8525