Provider Demographics
NPI:1376584011
Name:SAVAGE, LEONARD DEWITT (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:DEWITT
Last Name:SAVAGE
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 1:480 NE A ST
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-1844
Mailing Address - Country:US
Mailing Address - Phone:541-475-4800
Mailing Address - Fax:541-475-4805
Practice Address - Street 1:480 NE A ST
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1844
Practice Address - Country:US
Practice Address - Phone:541-475-4800
Practice Address - Fax:541-475-4805
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR-MD20061207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OROR-MD20061OtherOREGON MEDICAL LICENSE