Provider Demographics
NPI:1063503696
Name:LEONETTI, JOSEPH PATRICK (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:LEONETTI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 E BELL RD
Mailing Address - Street 2:STE 121
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2238
Mailing Address - Country:US
Mailing Address - Phone:602-992-1120
Mailing Address - Fax:602-971-5281
Practice Address - Street 1:4045 E BELL RD STE 121
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2238
Practice Address - Country:US
Practice Address - Phone:602-992-1120
Practice Address - Fax:602-971-5281
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDPM325213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5838930001Medicare NSC
AZUO9911Medicare UPIN
AZZ64910Medicare ID - Type Unspecified