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NPI Code Detail

MEDICARE: DR. MORGAN R. LEACH O.D.

MEDICARE:  DR. MORGAN R. LEACH  O.D.
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
1152W00000XOptometrist534 OPTMT
2152WX0102XOccupational Vision Optometrist534 OPTMT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2410041206OTHERMTRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10679000001OTHERMTDMERC
3027590OTHERMTBCBS OF MT
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215930557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MORGAN R. LEACH O.D.
Provider Business Mailing Address
First Line : 1900 4TH ST NE
Second Line : SUITE 5
City : GREAT FALLS
State : MT
Zip : 59404-1996
Country : US
Telephone Number : 406-453-1900
Fax Number : 406-453-1700
Provider Business Practice Location Address
First Line : 1900 4TH ST NE
Second Line : SUITE 5
City : GREAT FALLS
State : MT
Zip : 59404-1996
Country : US
Telephone Number : 406-453-1900
Fax Number : 406-453-1700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 10/24/2014

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Directions to “ DR. MORGAN R. LEACH O.D.” Practice Location

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