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General NPI Number Information
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NPI Number | 1861489734
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Entity Type | Individual
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Provider Name | RICHARD MATTHEW LEIGHTON DO
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Gender | Male
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 20 MEDICAL CAMPUS DR SUITE 104
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City | SUPPLY
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State | NC
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Zip | 28462-4094
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Country | US
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Telephone | 910-575-5800
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Fax | 910-579-1174
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 732
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 9600283
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License Number State | NC
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