Provider Demographics
NPI:1558383869
Name:LEONARD, JOSHUA C (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:C
Last Name:LEONARD
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 1:440 SCOTT ROLEN DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-2700
Mailing Address - Country:US
Mailing Address - Phone:812-482-5656
Mailing Address - Fax:812-481-1806
Practice Address - Street 1:440 SCOTT ROLEN DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-2700
Practice Address - Country:US
Practice Address - Phone:812-482-5656
Practice Address - Fax:812-481-1806
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064692A207RC0000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200902710Medicaid
NC5900701Medicaid
IN200902710Medicaid
2037383AMedicare ID - Type Unspecified
254830EMedicare PIN