Provider Demographics
NPI:1497724959
Name:REID, LEON A III (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:A
Last Name:REID
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5535 FAIR LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3434
Mailing Address - Country:US
Mailing Address - Phone:513-221-5274
Mailing Address - Fax:513-961-5100
Practice Address - Street 1:4631 RIDGE AVE
Practice Address - Street 2:STE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1028
Practice Address - Country:US
Practice Address - Phone:513-861-3377
Practice Address - Fax:513-861-3759
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-045315207W00000X
VA0101030207207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH180032054OtherRAILROAD MEDICARE
OH0435149Medicaid
OH0483576Medicare PIN
OH0483574Medicare PIN
OH180032054OtherRAILROAD MEDICARE
OH0483575Medicare PIN
OHA79688Medicare UPIN
OH0435149Medicaid
OH0483578Medicare PIN