Provider Demographics
NPI:1699131987
Name:LEONARD, JAMES (RPH)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:LEONARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 PETZOLDT DR
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2044
Mailing Address - Country:US
Mailing Address - Phone:513-919-0936
Mailing Address - Fax:
Practice Address - Street 1:6105 PETZOLDT DR
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2044
Practice Address - Country:US
Practice Address - Phone:513-919-0936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-03
Last Update Date:2016-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist