Provider Demographics
NPI:1942292958
Name:LEONARD, THOMAS E (OD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:LEONARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 SW GAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3337
Mailing Address - Country:US
Mailing Address - Phone:785-272-7066
Mailing Address - Fax:785-272-9987
Practice Address - Street 1:1911 SW GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3337
Practice Address - Country:US
Practice Address - Phone:785-272-7066
Practice Address - Fax:785-272-9987
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1103-2152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000005227OtherBLUE CROSS BLUE SHIELD
KS005227Medicare PIN
KS0355570001Medicare NSC
KST43708Medicare UPIN
KS540004012Medicare PIN