Healthcare Provider Details

I. General information

NPI: 1730428244
Provider Name (Legal Business Name): STEVEN LEIBSOHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9290 E THOMPSON PEAK PKWY 422
SCOTTSDALE AZ
85255-4507
US

IV. Provider business mailing address

9290 E THOMPSON PEAK PKWY 422
SCOTTSDALE AZ
85255-4507
US

V. Phone/Fax

Practice location:
  • Phone: 623-202-7114
  • Fax:
Mailing address:
  • Phone: 623-202-7114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number17701
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: