Healthcare Provider Details

I. General information

NPI: 1124255294
Provider Name (Legal Business Name): GERARD FRANCIS LEAHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

10401 W THUNDERBIRD BLVD
SUN CITY AZ
85351-3004
US

V. Phone/Fax

Practice location:
  • Phone: 602-239-2296
  • Fax:
Mailing address:
  • Phone: 623-832-4728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number45904
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: