Healthcare Provider Details

I. General information

NPI: 1447456264
Provider Name (Legal Business Name): LEAH JANE CONBOY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS LEAH JANE DAIG

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 US HIGHWAY 23 N
ALPENA MI
49707-7938
US

IV. Provider business mailing address

PO BOX 655
ALPENA MI
49707-0655
US

V. Phone/Fax

Practice location:
  • Phone: 989-358-3475
  • Fax: 989-358-3775
Mailing address:
  • Phone: 989-356-4049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101017389
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: