Provider Demographics
NPI:1760475461
Name:WALSH, LEIGH STRAUS (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:STRAUS
Last Name:WALSH
Suffix:
Gender:F
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:PO BOX 780982
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0982
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:200 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1831
Practice Address - Country:US
Practice Address - Phone:502-629-8000
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37113207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64056518Medicaid
KY000000724266OtherANTHEM - WS
KY500034480OtherPASSPORT - WS
IN201040520Medicaid
KY000057120NOtherHUMANA - WS
KY040116OtherSIHO - WS
5581OtherGRP MEDICARE
KY6427069OtherCIGNA-WS
LA1558106Medicare PIN
KY000000724266OtherANTHEM - WS
H59595Medicare UPIN
KYK007800Medicare PIN
65925109OtherGRP MEDICAID