MEDICARE: DR. LEON E DANTZLER M.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
1	208M00000X	Hospitalist Physician	39256	NC
2	207R00000X	Internal Medicine Physician	39256	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285637397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON E DANTZLER M.D.

Provider Business Mailing Address
First Line	:	5221 PARAMOUNT PKWY STE 220
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-5490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 ROBESON ST
Second Line	:	SUITE 300
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5552
Country	:	US
Telephone Number	:	910-609-1617
Fax Number	:	910-609-1618

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/02/2025

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Directions to “ DR. LEON E DANTZLER M.D.” Practice Location

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