Provider Demographics
NPI:1669609426
Name:JOSEPH P LEONETTI DPM PC
Entity type:Organization
Organization Name:JOSEPH P LEONETTI DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LEONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:602-992-1120
Mailing Address - Street 1:4045 E BELL RD
Mailing Address - Street 2:#121
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2236
Mailing Address - Country:US
Mailing Address - Phone:602-992-1120
Mailing Address - Fax:602-971-5281
Practice Address - Street 1:4045 E BELL RD
Practice Address - Street 2:#121
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2236
Practice Address - Country:US
Practice Address - Phone:602-992-1120
Practice Address - Fax:602-971-5281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0325213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ64910Medicare PIN
AZU09911Medicare UPIN