Provider Demographics
NPI:1912031469
Name:DILLON, LEAYN JUNE (DO)
Entity Type:Individual
Prefix:MRS
First Name:LEAYN
Middle Name:JUNE
Last Name:DILLON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 20TH ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3859
Mailing Address - Country:US
Mailing Address - Phone:307-637-7700
Mailing Address - Fax:307-637-5672
Practice Address - Street 1:800 E 20TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3859
Practice Address - Country:US
Practice Address - Phone:307-637-7700
Practice Address - Fax:307-637-5672
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7826A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY126254800Medicaid
WY126254800Medicaid