Provider Demographics
NPI:1801853080
Name:LEIGHTY, JASON RICHARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:RICHARD
Last Name:LEIGHTY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 OAKBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1361
Mailing Address - Country:US
Mailing Address - Phone:813-545-6187
Mailing Address - Fax:727-797-7161
Practice Address - Street 1:3034 OAKBROOK CIR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1361
Practice Address - Country:US
Practice Address - Phone:813-545-6187
Practice Address - Fax:727-797-7161
Is Sole Proprietor?:No
Enumeration Date:2006-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist