Healthcare Provider Details

I. General information

NPI: 1457318974
Provider Name (Legal Business Name): LEONARD J JANCHAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 S MAIN ST
MARION OH
43302
US

IV. Provider business mailing address

181 S MAIN ST
MARION OH
43302-3964
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-7927
  • Fax: 740-383-7942
Mailing address:
  • Phone: 740-387-6520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.033560
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: