Provider Demographics
NPI:1457462103
Name:DELAIR, LEIGH A (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:A
Last Name:DELAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MENELAUS RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-9748
Mailing Address - Country:US
Mailing Address - Phone:877-423-1330
Mailing Address - Fax:859-228-1567
Practice Address - Street 1:2200 MENELAUS RD
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-9748
Practice Address - Country:US
Practice Address - Phone:877-423-1330
Practice Address - Fax:859-228-1567
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000538803OtherANTHEM
CA00A868860Medicaid
C92507OtherCUMBERLAND HEALTHCARE
0594457Medicare PIN
000000538803OtherANTHEM