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General NPI Number Information
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NPI Number | 1912571662
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Entity Type | Individual
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Provider Name | JOSEPH M LEON DO
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Gender | Male
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 601 GROVE AVE
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City | WILD ROSE
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State | WI
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Zip | 54984-6903
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Country | US
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Telephone | 920-622-3257
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Fax | 920-622-6021
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-830-5900
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Fax | 920-830-5910
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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 | 81559
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License Number State | WI
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