Healthcare Provider Details

I. General information

NPI: 1487823506
Provider Name (Legal Business Name): LEONARD CHRISTOPHER TREANOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42388 PELICAN PROFESSIONAL PARK
HAMMOND LA
70403-2412
US

IV. Provider business mailing address

PO BOX 1799
HAMMOND LA
70404-1799
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-6251
  • Fax: 985-345-2386
Mailing address:
  • Phone: 985-542-6251
  • Fax: 985-345-2386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number203457
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number203457
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number203457
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number23274
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: