Provider Demographics
NPI:1073104634
Name:LEONARD, EDWARD CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:CRAIG
Last Name:LEONARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 N DEAN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5148
Mailing Address - Country:US
Mailing Address - Phone:334-821-4493
Mailing Address - Fax:334-821-4496
Practice Address - Street 1:464 N DEAN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5148
Practice Address - Country:US
Practice Address - Phone:334-821-4493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL10468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist