MEDICARE: TRENTON JARED LEO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	36.004145	OH

General Provider Information

NPI Number	:	1114508322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRENTON JARED LEO DPM

Provider Business Mailing Address
First Line	:	680 BUCKLES CT N STE 2A
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6928
Country	:	US
Telephone Number	:	614-339-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 BUCKLES CT N STE 2A
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6928
Country	:	US
Telephone Number	:	614-339-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	01/24/2026

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Directions to “ TRENTON JARED LEO DPM” Practice Location

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