Provider Demographics
NPI:1285712026
Name:NOTTO, LEONARD ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ANTHONY
Last Name:NOTTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 E PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-4106
Mailing Address - Country:US
Mailing Address - Phone:479-858-7176
Mailing Address - Fax:479-858-7176
Practice Address - Street 1:619 E PARKWAY DR
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-4106
Practice Address - Country:US
Practice Address - Phone:479-858-7176
Practice Address - Fax:479-858-7176
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5803430OtherAETNA
AR5T437OtherBCBS
AR5T437OtherBCBS
ARU63821Medicare UPIN