MEDICARE: LEON J GROBLER MD

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	27697	AZ

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	:	1376583542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEON J GROBLER MD

Provider Business Mailing Address
First Line	:	13640 N PLAZA DEL RIO BLVD
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85381-4846
Country	:	US
Telephone Number	:	623-876-3800
Fax Number	:	623-972-9590

Provider Business Practice Location Address
First Line	:	13188 N 103RD DR
Second Line	:	STE 209
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3064
Country	:	US
Telephone Number	:	623-876-3870
Fax Number	:	623-815-0087

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/09/2007

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Directions to “ LEON J GROBLER MD” Practice Location

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