Provider Demographics
NPI:1205018306
Name:DONALD G LEONARD MD RHEUMATOLOGY CLINIC PA
Entity Type:Organization
Organization Name:DONALD G LEONARD MD RHEUMATOLOGY CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLYARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-261-7171
Mailing Address - Street 1:3 OFFICE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3843
Mailing Address - Country:US
Mailing Address - Phone:501-224-6778
Mailing Address - Fax:501-224-4862
Practice Address - Street 1:3 OFFICE PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3843
Practice Address - Country:US
Practice Address - Phone:501-224-6778
Practice Address - Fax:501-224-4862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR2497207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116713002Medicaid
AR57240Medicare PIN