Healthcare Provider Details

I. General information

NPI: 1497746051
Provider Name (Legal Business Name): LEONARD WORTLEY AAMODT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 LUCY DR
HARRISONBURG VA
22801-8036
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-438-1314
  • Fax: 540-438-0797
Mailing address:
  • Phone: 540-438-1314
  • Fax: 540-932-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number50215
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: