Provider Demographics
NPI:1376726612
Name:LEONARD, CHRISTOPHER JAMES (DO)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:LEONARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 HOSPITAL DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1929
Mailing Address - Country:US
Mailing Address - Phone:276-670-7040
Mailing Address - Fax:276-670-7041
Practice Address - Street 1:300 71ST STREET
Practice Address - Street 2:SUITE 620
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3089
Practice Address - Country:US
Practice Address - Phone:305-866-9951
Practice Address - Fax:305-614-3352
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2285-T208600000X
VA0102202281208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1376726612Medicaid
VA019462V94Medicare PIN