Provider Demographics
NPI:1134301922
Name:LEIGHTON, JOSHUA CHAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:CHAMAN
Last Name:LEIGHTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 OLNEY ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1663
Mailing Address - Country:US
Mailing Address - Phone:615-202-1872
Mailing Address - Fax:
Practice Address - Street 1:65 SOCKANOSSET CROSS RD
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-5536
Practice Address - Country:US
Practice Address - Phone:401-886-4830
Practice Address - Fax:888-779-7670
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2014-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD144012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIJL94600Medicaid
RIU400105107Medicare PIN