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General NPI Number Information
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NPI Number | 1356436703
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Entity Type | Individual
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Provider Name | RODNEY OWEN LEACOCK M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 3 RICHLAND MEDICAL PARK DR STE 310
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City | COLUMBIA
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State | SC
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Zip | 29203-6862
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Country | US
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Telephone | 803-434-8323
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Fax | 803-296-8326
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 803-434-6412
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Fax | 803-296-7330
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 200300373
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 35018
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License Number State | SC
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