Provider Demographics
NPI:1669473393
Name:LEONARD, M. DENICE (DO)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:DENICE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 ONEIDA VALLEY RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2252
Mailing Address - Country:US
Mailing Address - Phone:844-765-2845
Mailing Address - Fax:724-431-1668
Practice Address - Street 1:129 ONEIDA VALLEY RD
Practice Address - Street 2:SUITE 211
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2252
Practice Address - Country:US
Practice Address - Phone:844-765-2845
Practice Address - Fax:724-431-1668
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007038E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012196610012Medicaid
WV3810005924Medicaid
WV3810005924Medicaid
PA614190NHHMedicare PIN