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NPI Code Detail

MEDICARE: W HUGH LEEDY M.D.

MEDICARE: W HUGH LEEDY 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
1207Q00000XFamily Medicine PhysicianM3333ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326045865
Entity Type Code : Individual
Provider Name (Legal Business Name) : W HUGH LEEDY M.D.
Provider Business Mailing Address
First Line : 6635 COMANCHE ST
Second Line : PO BOX Q
City : BONNERS FERRY
State : ID
Zip : 83805-7523
Country : US
Telephone Number : 208-267-1718
Fax Number : 208-267-7739
Provider Business Practice Location Address
First Line : 1327 SUPERIOR ST
Second Line :
City : SANDPOINT
State : ID
Zip : 83864-1735
Country : US
Telephone Number : 208-263-1718
Fax Number : 208-263-7198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 06/16/2009

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Directions to “ W HUGH LEEDY M.D.” Practice Location

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