Provider Demographics
NPI:1104871409
Name:JAMES M LEIPZIG MD PC
Entity type:Organization
Organization Name:JAMES M LEIPZIG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEIPZIG
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:540-725-9771
Mailing Address - Street 1:PO BOX 12286
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24024-2286
Mailing Address - Country:US
Mailing Address - Phone:540-725-9771
Mailing Address - Fax:540-725-3624
Practice Address - Street 1:1940 BRAEBURN CIR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7388
Practice Address - Country:US
Practice Address - Phone:540-725-9771
Practice Address - Fax:540-275-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08747Medicare PIN