Healthcare Provider Details

I. General information

NPI: 1013927458
Provider Name (Legal Business Name): DAVID P. LEACHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 E LOHMAN AVE
LAS CRUCES NM
88011-8255
US

IV. Provider business mailing address

4311 E LOHMAN AVE
LAS CRUCES NM
88011-8255
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-7615
  • Fax: 575-556-7619
Mailing address:
  • Phone: 575-556-7615
  • Fax: 575-556-7619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2003-0117
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: