Provider Demographics
NPI:1891865911
Name:JAMES S LEONARD, DPM PC
Entity Type:Organization
Organization Name:JAMES S LEONARD, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:607-756-5422
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-0246
Mailing Address - Country:US
Mailing Address - Phone:607-756-5422
Mailing Address - Fax:607-756-5488
Practice Address - Street 1:12 GROTON AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-0246
Practice Address - Country:US
Practice Address - Phone:607-756-5422
Practice Address - Fax:607-756-5488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004037-1213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1106Medicare PIN
NY4442360001Medicare NSC