Provider Demographics
NPI:1366486714
Name:LEIPZIG, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:LEIPZIG
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 1:1940 BRAEBURN CIR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7388
Mailing Address - Country:US
Mailing Address - Phone:540-725-9771
Mailing Address - Fax:540-725-3624
Practice Address - Street 1:1940 BRAEBURN CIR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7388
Practice Address - Country:US
Practice Address - Phone:540-725-9771
Practice Address - Fax:540-725-3624
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048302207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006405681Medicaid
VA1366486714Medicaid
VAP01250319Medicare PIN
VAVVB102AMedicare PIN
F01393Medicare UPIN
VA00V472J47Medicare PIN