Healthcare Provider Details

I. General information

NPI: 1255345955
Provider Name (Legal Business Name): LEON B BRIGGS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 23RD ST STE 8B
ASHLAND KY
41101-2845
US

IV. Provider business mailing address

PO BOX 2379
ASHLAND KY
41105-2379
US

V. Phone/Fax

Practice location:
  • Phone: 606-408-1290
  • Fax: 606-408-6640
Mailing address:
  • Phone: 606-408-6602
  • Fax: 606-408-6612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number32774
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: