Provider Demographics
NPI:1154577971
Name:LEONARD, LAWRENCE MARVIN (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MARVIN
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 AMERESCOGGIN RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1523
Mailing Address - Country:US
Mailing Address - Phone:207-781-2426
Mailing Address - Fax:
Practice Address - Street 1:26 AMERESCOGGIN RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1523
Practice Address - Country:US
Practice Address - Phone:207-781-2426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME005984207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery