Provider Demographics
NPI:1962471003
Name:JOSEPHS, LEON G (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:G
Last Name:JOSEPHS
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 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-368-3190
Mailing Address - Fax:508-368-3193
Practice Address - Street 1:123 SUMMER ST STE 210
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-368-3190
Practice Address - Fax:508-368-3193
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA568202086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherHEALTHCARE VALUE MGMT
042472266OtherPRIVATE HEALTHCARE SYSTEM
J06987OtherBLUE SHIELD INDEMNITY
2044702OtherFIRST HEALTH
5060175OtherAETNA US HEALTCARE
J06987OtherBLUE SHIELD HMO BLUE
AA5965OtherHARVARD PILGRIM HEALTHCAR
042472266OtherONE HEALTH PLAN
2900343OtherEVERCARE
3030351OtherMEDICAID WELFARE
J06987OtherBLUE CARE ELECT
5068965OtherCIGNA HEALTH PLAN
J06987OtherMEDICARE B
3030351OtherHEALTHY START
MA3030351Medicaid
33794OtherFALLON COMMUNITY HEALTH P
784032OtherMVP HEALTH CARE
784033OtherMVP HEALTH CARE
784032OtherMVP HEALTH CARE
MA3030351Medicaid