Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 0101271222 | VA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 33926 | AZ |
NPI | 1114981495 |
---|---|
Provider Name | Dr. Jordan Christopher Leonard |
First Address | Phoenix, AZ 85020-4492 |
Second Address | Rockingham, VA 22801-8679 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 11/01/2021 |