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General NPI Number Information
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NPI Number | 1124085709
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Entity Type | Individual
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Provider Name | ERIC EDWARD LEONHEART DPM
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVENUE MADIGAN ARMY MEDICAL CENTER
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City | TACOMA
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State | WA
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Zip | 98431-5820
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Country | US
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Telephone | 253-968-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 121 SW 299TH PL
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City | FEDERAL WAY
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State | WA
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Zip | 98023-3572
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Country | US
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Telephone | 425-233-4597
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Fax | 425-656-4096
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO-00000778
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License Number State | WA
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