Provider Demographics
NPI:1245224310
Name:ARCENAS, LEIGHTON V (MD)
Entity Type:Individual
Prefix:
First Name:LEIGHTON
Middle Name:V
Last Name:ARCENAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 E RUSHOLME ST
Mailing Address - Street 2:COGENT OFFICE MOB I
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2453
Mailing Address - Country:US
Mailing Address - Phone:563-421-3122
Mailing Address - Fax:
Practice Address - Street 1:801 ILLINI DR
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-1804
Practice Address - Country:US
Practice Address - Phone:309-792-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27859207R00000X
IL036-066279207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1240005OtherILLINOIS MEDICARE
IL421060724002Medicaid
IL8122859OtherILLINOIS BC/BS
IA0080200Medicaid
IA019489OtherIOWA BC/BS
IA1234733OtherCONTROLLED SUBSTANCE #
IA42106072439OtherJOHN DEERE HEALTH
IAIA0139OtherJOHN DEERE EDI #
IA067240OtherHEALTH ALLIANCE #
IA067240OtherHEALTH ALLIANCE #
IL8122859OtherILLINOIS BC/BS
IAIA0139OtherJOHN DEERE EDI #
IA1234733OtherCONTROLLED SUBSTANCE #
IA42106072439OtherJOHN DEERE HEALTH
IAE67655Medicare UPIN