Provider Demographics
NPI:1295276210
Name:LEON MEAD MD PA
Entity type:Organization
Organization Name:LEON MEAD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-262-1629
Mailing Address - Street 1:730 GOODLETTE RD N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5616
Mailing Address - Country:US
Mailing Address - Phone:239-262-1629
Mailing Address - Fax:239-262-2657
Practice Address - Street 1:730 GOODLETTE RD N
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5616
Practice Address - Country:US
Practice Address - Phone:239-262-1629
Practice Address - Fax:239-262-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty