Provider Demographics
NPI:1568629954
Name:LEONARD R NYLAND, MD,PLLC
Entity Type:Organization
Organization Name:LEONARD R NYLAND, MD,PLLC
Other - Org Name:PRIMARY CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:NYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-427-0281
Mailing Address - Street 1:723 AYERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-1505
Mailing Address - Country:US
Mailing Address - Phone:336-427-0281
Mailing Address - Fax:336-427-8084
Practice Address - Street 1:723 AYERSVILLE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1505
Practice Address - Country:US
Practice Address - Phone:336-427-0281
Practice Address - Fax:336-427-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC147952207Q00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty