Provider Demographics
NPI:1124096524
Name:LEON & LEON, M.D., P.A
Entity type:Organization
Organization Name:LEON & LEON, M.D., P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:CMM
Authorized Official - Phone:301-645-9551
Mailing Address - Street 1:3261 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 3010
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3223
Mailing Address - Country:US
Mailing Address - Phone:301-645-9551
Mailing Address - Fax:301-645-0039
Practice Address - Street 1:3261 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 3010
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3223
Practice Address - Country:US
Practice Address - Phone:301-645-9551
Practice Address - Fax:301-645-0039
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEON & LEON, M.D., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-10
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD752341600Medicaid
MDK870Medicare PIN