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General NPI Number Information
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NPI Number | 1619489283
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Entity Type | Organization
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Legal Business Name | PRIVATE PHYSICIANS MEDICAL PRACTICE, LLC
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 5700 CORPORATE DR STE 265
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City | PITTSBURGH
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State | PA
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Zip | 15237-5861
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Country | US
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Telephone | 412-369-5900
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Fax | 412-369-5905
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Provider Business Mailing Address
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Address Line | 10675 PERRY HWY UNIT 243
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City | WEXFORD
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State | PA
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Zip | 15090-1129
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Country | US
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Telephone | 412-369-5900
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Fax | 412-369-5905
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT LEONE
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Credential | DO
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Telephone | 412-369-5900
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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 | OS006326L
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License Number State | PA
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