MEDICARE: M. DENICE LEONARD DO

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	OS007038E	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669473393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	M. DENICE LEONARD DO

Provider Business Mailing Address
First Line	:	129 ONEIDA VALLEY RD
Second Line	:	SUITE 211
City	:	BUTLER
State	:	PA
Zip	:	16001-2252
Country	:	US
Telephone Number	:	844-765-2845
Fax Number	:	724-431-1668

Provider Business Practice Location Address
First Line	:	129 ONEIDA VALLEY RD
Second Line	:	SUITE 211
City	:	BUTLER
State	:	PA
Zip	:	16001-2252
Country	:	US
Telephone Number	:	844-765-2845
Fax Number	:	724-431-1668

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	08/06/2020

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Directions to “ M. DENICE LEONARD DO” Practice Location

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