Healthcare Provider Details

I. General information

NPI: 1376954701
Provider Name (Legal Business Name): DORIAN KENLEIGH MD, MPH, FACOEM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 E CAMELBACK RD STE 1226
PHOENIX AZ
85016-4502
US

IV. Provider business mailing address

3104 E CAMELBACK RD STE 1226
PHOENIX AZ
85016-4502
US

V. Phone/Fax

Practice location:
  • Phone: 602-989-2642
  • Fax: 623-401-7258
Mailing address:
  • Phone: 602-989-2642
  • Fax: 623-401-7258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License Number14130703-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License Number01076045A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License NumberC167244
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2083T0002X
TaxonomyMedical Toxicology (Preventive Medicine) Physician
License Number58925
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number14130703-1205
License Number StateUT
# 6
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number01076045A
License Number StateIN
# 7
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number58925
License Number StateAZ
# 8
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD61188901
License Number StateWA
# 9
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberC167244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: