Provider Demographics
NPI:1558924787
Name:LEONARD, PERRY JAMES JR (MD, MSPH, MHS)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:JAMES
Last Name:LEONARD
Suffix:JR
Gender:M
Credentials:MD, MSPH, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 N 1700 W SUITE A
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-773-8544
Mailing Address - Fax:
Practice Address - Street 1:2084 N 1700 W SUITE A
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-773-8644
Practice Address - Fax:801-773-9828
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180517208000000X
UT14164875-1205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics