Provider Demographics
NPI:1770590614
Name:LEONG, JONATHAN G (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:G
Last Name:LEONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:168TH MED BN UNIT 15021
Mailing Address - Street 2:BOX 28B
Mailing Address - City:APO AP
Mailing Address - State:CA
Mailing Address - Zip Code:96218-9998
Mailing Address - Country:US
Mailing Address - Phone:011-822-7916
Mailing Address - Fax:
Practice Address - Street 1:18TH MEDCOM
Practice Address - Street 2:ATTN: DCCS-QM(CREDENTIALS)
Practice Address - City:APO AP
Practice Address - State:KOREA
Practice Address - Zip Code:96205-0054
Practice Address - Country:KR
Practice Address - Phone:0118227-916-6027
Practice Address - Fax:0118227-917-6027
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
NE192562083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine