Healthcare Provider Details

I. General information

NPI: 1265681159
Provider Name (Legal Business Name): DAVID G. LEONARD, M.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 E HOLLISTER ST
CINCINNATI OH
45219-1704
US

IV. Provider business mailing address

58 E HOLLISTER ST
CINCINNATI OH
45219-1704
US

V. Phone/Fax

Practice location:
  • Phone: 513-721-1737
  • Fax: 513-287-7465
Mailing address:
  • Phone: 513-721-1737
  • Fax: 513-287-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number81242
License Number StateOH

VIII. Authorized Official

Name: DAVID G. LEONARD
Title or Position: OWNER
Credential: M.D.
Phone: 513-721-1737