Provider Demographics
NPI:1215992201
Name:KRAYBILL, LEON (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:
Last Name:KRAYBILL
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 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:2110 HARRISBURG PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3022
Practice Address - Fax:717-544-3021
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037155E207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1417245OtherAETNA - HMO
PA4662916OtherAETNA - NON HMO
PA000000145776OtherUNISON
PA0111009000OtherAMERIHEALTH 65 / IBC
PAP00053719OtherRAILROAD MEDICARE
PA0011160470005Medicaid
PA15640OtherGEISINGER HEALTH PLAN
PAP002670OtherGATEWAY
PA000516905OtherHIGHMARK BLUE SHIELD
PA50055984OtherCAPITAL BLUE CROSS
PA1417245OtherAETNA - HMO