Healthcare Provider Details

I. General information

NPI: 1386653772
Provider Name (Legal Business Name): KIRK W LEININGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E MALL DR
ST GEORGE UT
84790-1954
US

IV. Provider business mailing address

1055 N 500 W ATTN CREDENTIALING
PROVO UT
84604
US

V. Phone/Fax

Practice location:
  • Phone: 435-656-8800
  • Fax: 435-627-1809
Mailing address:
  • Phone: 801-354-8225
  • Fax: 801-418-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5405900-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: