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General NPI Number Information
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NPI Number | 1124607577
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Entity Type | Individual
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Provider Name | ETHAN LEABHART DO
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Gender | Male
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1120 FAIRGROVE CHURCH RD STE 12
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City | HICKORY
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State | NC
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Zip | 28602-9630
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Country | US
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Telephone | 828-326-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 810 FAIRGROVE CHURCH RD
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City | HICKORY
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State | NC
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Zip | 28602-9617
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2025-00920
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License Number State | NC
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