Provider Demographics
NPI:1417949496
Name:TROUT, LEONARD E III (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:E
Last Name:TROUT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1218 WOODED KNL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 C ST W
Practice Address - Street 2:HQ AFPC/DPAMM
Practice Address - City:RANDOLPH A F B
Practice Address - State:TX
Practice Address - Zip Code:78150-4702
Practice Address - Country:US
Practice Address - Phone:210-565-0668
Practice Address - Fax:210-565-2354
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY5651-A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine