MEDICARE: LEIGH WATLINGTON 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	207V00000X	Obstetrics & Gynecology Physician	D0032635	MD
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	0101038431	VA

General Provider Information

NPI Number	:	1306837034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH WATLINGTON M.D.

Provider Business Mailing Address
First Line	:	615 ELSINORE PL STE 200
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-1457
Country	:	US
Telephone Number	:	513-834-7063
Fax Number	:

Provider Business Practice Location Address
First Line	:	5001 W VILLAGE GREEN DR STE 205
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-4801
Country	:	US
Telephone Number	:	513-834-7063
Fax Number	:

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	12/21/2021

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