Provider Demographics
NPI:1316078785
Name:HAROLD F. LEEPER, M.D., PH.D., INC.
Entity type:Organization
Organization Name:HAROLD F. LEEPER, M.D., PH.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:LEEPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:304-234-2020
Mailing Address - Street 1:PO BOX 6252
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0726
Mailing Address - Country:US
Mailing Address - Phone:304-234-2020
Mailing Address - Fax:304-234-7158
Practice Address - Street 1:58 16TH ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3660
Practice Address - Country:US
Practice Address - Phone:304-234-2020
Practice Address - Fax:304-234-7158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16379207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0095403000Medicaid
OH0741602Medicaid
WV4015101Medicare ID - Type Unspecified
WVE12832Medicare UPIN