Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | DPM325 | AZ |
NPI | 1063503696 |
---|---|
Provider Name | Dr. Joseph Patrick Leonetti |
First Address | Phoenix, AZ 85032-2238 |
Second Address | Phoenix, AZ 85032-2238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 14/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
UO9911 | (02) | AZ |