Provider Demographics
NPI:1033189295
Name:BEARD, LEIGH ANN CARTER (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH ANN
Middle Name:CARTER
Last Name:BEARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SHAKER DR STE 132
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3663
Mailing Address - Country:US
Mailing Address - Phone:859-288-5004
Mailing Address - Fax:859-288-5007
Practice Address - Street 1:715 SHAKER DR STE 132
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3663
Practice Address - Country:US
Practice Address - Phone:859-288-5004
Practice Address - Fax:859-288-5007
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40054207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY71000674Medicaid
KYP00605703OtherRAILROAD MEDICARE
KY71000674Medicaid
KYP00605703OtherRAILROAD MEDICARE