Provider Demographics
NPI:1649413386
Name:YOUNG, LEIGH ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEIGH
Other - Middle Name:ANNE YOUNG
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:280 FRANK B. SMITH DRIVE,
Mailing Address - Street 2:
Mailing Address - City:WEBER CITY
Mailing Address - State:VA
Mailing Address - Zip Code:24290
Mailing Address - Country:US
Mailing Address - Phone:276-409-0005
Mailing Address - Fax:276-690-2678
Practice Address - Street 1:280 FRANK B. SMITH DRIVE
Practice Address - Street 2:
Practice Address - City:WEBER CITY
Practice Address - State:VA
Practice Address - Zip Code:24290
Practice Address - Country:US
Practice Address - Phone:276-409-0005
Practice Address - Fax:276-690-2678
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-10
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27903207R00000X
VA0101258941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF64284Medicare UPIN