Provider Demographics
NPI:1720005499
Name:LEON, ZELKO (MD)
Entity Type:Individual
Prefix:
First Name:ZELKO
Middle Name:
Last Name:LEON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 W SR 89A STE 2
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5100
Mailing Address - Country:US
Mailing Address - Phone:928-202-9187
Mailing Address - Fax:928-202-4666
Practice Address - Street 1:2855 W SR 89A STE 2
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5100
Practice Address - Country:US
Practice Address - Phone:928-282-9187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ571872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN25437Medicare PIN
E64912Medicare UPIN