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NPI Code Detail

MEDICARE: MR. EUGENE JOSEPH VAN LEEUWEN MD

MEDICARE:  MR. EUGENE JOSEPH VAN LEEUWEN  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
12084P0804XChild & Adolescent Psychiatry Physician35055807OH
22084P0805XGeriatric Psychiatry Physician35055807OH
32084P0800XPsychiatry Physician35055807OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4260046462OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11500842OTHEREVERCARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000196583OTHEROHANTHEM
531176049300OTHEROHBWC
6198316000OTHERMAGELLAN
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932117959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EUGENE JOSEPH VAN LEEUWEN MD
Provider Business Mailing Address
First Line : 3001 HIGHLAND AVE.
Second Line : SUITE E
City : CINCINNATI
State : OH
Zip : 45219-2315
Country : US
Telephone Number : 513-961-8861
Fax Number : 513-487-3770
Provider Business Practice Location Address
First Line : 3001 HIGHLAND AVE.
Second Line : SUITE E
City : CINCINNATI
State : OH
Zip : 45219-2315
Country : US
Telephone Number : 513-961-8861
Fax Number : 513-487-3770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 05/22/2023

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Directions to “ MR. EUGENE JOSEPH VAN LEEUWEN MD” Practice Location

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