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General NPI Number Information
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NPI Number | 1134232515
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Entity Type | Individual
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Provider Name | BETH A LEONE DO
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 835 CRATER LAKE AVE
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City | MEDFORD
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State | OR
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Zip | 97504-6505
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Country | US
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Telephone | 541-773-7717
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Fax |
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Provider Business Mailing Address
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Address Line | 551 N MAIN ST
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City | ASHLAND
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State | OR
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Zip | 97520-1707
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Country | US
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Telephone | 541-326-1872
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Fax | 541-708-0441
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO25699
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License Number State | OR
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