Provider Demographics
NPI:1639110455
Name:FOXX LEACH, ANN CHERI (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:CHERI
Last Name:FOXX LEACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:CHERI
Other - Last Name:FOXX LEACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4400 N SCOTTSDALE RD STE 805
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3331
Mailing Address - Country:US
Mailing Address - Phone:480-818-4009
Mailing Address - Fax:602-865-8171
Practice Address - Street 1:4400 N SCOTTSDALE RD UNIT 805
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3331
Practice Address - Country:US
Practice Address - Phone:480-818-4009
Practice Address - Fax:602-865-8171
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44778207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ172910Medicare PIN