Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 2003-0117 | NM |
NPI | 1013927458 |
---|---|
Provider Name | David P. Leachman |
First Address | Las Cruces, NM 88011-8255 |
Second Address | Las Cruces, NM 88011-8255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 03/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34589538 | (05) | NM |
I08596 | (02) | NM |