Stuart S Leicht
Internist Dermatologist Procedural Dermatology Pediatric Dermatologist
2898 Boones Creek Rd Ste 105
Johnson City
, Tennessee 37615-4976
Stuart S Leicht
Internist Dermatologist Procedural Dermatology Pediatric Dermatologist
2898 Boones Creek Rd Ste 105
Johnson City
, Tennessee 37615-4976
(423) 433-6060
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About
Features
Specialties
- Dermatologist
- Pediatric Dermatologist
- Procedural Dermatology
- Internist
Languages spoken
- English
Location
First Address
- Stuart S Leicht
- 2898 Boones Creek Rd Ste 105
- Johnson City, TN
- Zip : 37615-4976
- Fax : (423) 433-6060
- Phone : (423) 262-0112
Second Address
- Stuart S Leicht
- 2898 Boones Creek Rd Ste 105
- Johnson City, TN
- Zip : 37615-4976
- Phone : (423) 262-0112
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | MD17098 | TN |
| N | 207NP0225X | Pediatric Dermatologist | MD17098 | TN |
| N | 207NS0135X | Procedural Dermatology | MD17098 | TN |
| N | 207R00000X | Internist | MD17098 | TN |
| N | 111NI0900X | Internist | MD17098 | TN |
National Provider Identifier
| NPI | 1013902907 |
|---|---|
| Provider Name | Stuart S Leicht |
| First Address | Johnson City, TN 37615-4976 |
| Second Address | Johnson City, TN 37615-4976 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/09/2005 |
| Last Update Date | 03/04/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.