Provider Demographics
NPI:1306937768
Name:LEONE, KATHLEEN C (MD FACS)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:C
Last Name:LEONE
Suffix:
Gender:F
Credentials:MD FACS
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Mailing Address - Street 1:1729 NEW HANOVER MEDICAL PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403
Mailing Address - Country:US
Mailing Address - Phone:910-763-3601
Mailing Address - Fax:910-763-4608
Practice Address - Street 1:1729 NEW HANOVER MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-763-3601
Practice Address - Fax:910-763-4608
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9800608207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89115Medicaid
NC89115Medicaid
NC2257806CMedicare ID - Type Unspecified