Provider Demographics
NPI:1447231535
Name:MARTINEC, LEONARD W (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:W
Last Name:MARTINEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8371 HIGHWAY 72 W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9505
Mailing Address - Country:US
Mailing Address - Phone:256-722-0664
Mailing Address - Fax:256-722-0284
Practice Address - Street 1:8371 HIGHWAY 72 W
Practice Address - Street 2:SUITE 200
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9505
Practice Address - Country:US
Practice Address - Phone:256-722-0664
Practice Address - Fax:256-722-0284
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2007-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL3841207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72556Medicare UPIN