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General NPI Number Information
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NPI Number | 1861699548
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Entity Type | Individual
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Provider Name | LEANNA MARIE WITHROW DO
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 1430 COLUMBUS AVE
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-1703
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Country | US
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Telephone | 740-335-1210
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Fax |
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Provider Business Mailing Address
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Address Line | 700 ACKERMAN RD STE 2120
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City | COLUMBUS
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State | OH
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Zip | 43202-1559
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Country | US
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Telephone | 740-335-1210
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.009575
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 03249
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.009575
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License Number State | OH
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