Healthcare Provider Details

I. General information

NPI: 1851362842
Provider Name (Legal Business Name): JAMES LAWRENCE LEACH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVENUE RADIOLOGY, ML 5031
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVENUE RADIOLOGY, ML 5031
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4225
  • Fax: 513-636-2511
Mailing address:
  • Phone: 513-636-4225
  • Fax: 513-636-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35 062742
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number35.062742
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: