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NPI Code Detail

MEDICARE: DR. LEON R GROSS M.D.

MEDICARE: DR. LEON R GROSS 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
1207W00000XOphthalmology Physician016351GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
9180021438OTHERGARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
102874OTHERGACOVENTRY PPO
2582209517OTHERGAWORK COMP
34278685OTHERGAAETNA
4474665OTHERGAAETNA HMO
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6294526OTHERGAWELLCARE
7890558OTHERGAUHC
8442816OTHERGABCBS
105241OTHERGACOVENTRY HMO

General Provider Information

NPI Number : 1609873199
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEON R GROSS M.D.
Provider Business Mailing Address
First Line : 5901A PEACHTREE DUNWOODY RD NE
Second Line : STE 500
City : ATLANTA
State : GA
Zip : 30328-5382
Country : US
Telephone Number : 678-892-2020
Fax Number : 678-538-1950
Provider Business Practice Location Address
First Line : 5995 BARFIELD RD
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30328-4411
Country : US
Telephone Number : 404-256-1507
Fax Number : 404-256-1981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 11/15/2013

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Directions to “ DR. LEON R GROSS M.D.” Practice Location

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