Provider Demographics
NPI:1780630137
Name:QUICK, LEONARD DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:DENNIS
Last Name:QUICK
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 1:466 S TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3416
Mailing Address - Country:US
Mailing Address - Phone:419-756-8000
Mailing Address - Fax:419-756-7100
Practice Address - Street 1:466 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3416
Practice Address - Country:US
Practice Address - Phone:419-756-8000
Practice Address - Fax:419-756-7100
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045242207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4290005OtherAETNA
OH180012806OtherRAIL ROAD MEDICARE
OH0800239OtherUNITED HEALTHCARE
OH0551951Medicaid
OH341171920003OtherCIGNA
OH000000128146OtherANTHEM BC/BS
OH0546692Medicare ID - Type Unspecified
OH0800239OtherUNITED HEALTHCARE