Provider Demographics
NPI:1093729295
Name:WILLIAMS, LEIGH BRANDON (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEIGH
Middle Name:BRANDON
Last Name:WILLIAMS
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 1:917 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-1817
Mailing Address - Country:US
Mailing Address - Phone:757-487-3458
Mailing Address - Fax:757-487-4131
Practice Address - Street 1:1156 GEORGE WASHINGTON HWY N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-4908
Practice Address - Country:US
Practice Address - Phone:757-487-3458
Practice Address - Fax:757-487-4131
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist