Provider Demographics
NPI:1366715757
Name:G. GARY LEIGH, PH.D., P.C.
Entity type:Organization
Organization Name:G. GARY LEIGH, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:LEIGH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:423-718-4035
Mailing Address - Street 1:7155 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-0802
Mailing Address - Country:US
Mailing Address - Phone:423-553-7560
Mailing Address - Fax:423-648-9291
Practice Address - Street 1:7155 LEE HWY STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-0802
Practice Address - Country:US
Practice Address - Phone:423-553-7560
Practice Address - Fax:423-648-9291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTNP590103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0017400OtherBLUE SHIELD
TN3682315Medicaid
TN3682315Medicare PIN