Provider Demographics
NPI:1982889606
Name:JOSEPH J LEINWAND OD
Entity type:Organization
Organization Name:JOSEPH J LEINWAND OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:LEINWAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:910-592-3152
Mailing Address - Street 1:100 WARSAW RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328
Mailing Address - Country:US
Mailing Address - Phone:910-592-3152
Mailing Address - Fax:910-592-3153
Practice Address - Street 1:100 WARSAW RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328
Practice Address - Country:US
Practice Address - Phone:910-592-3152
Practice Address - Fax:910-592-3153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0953152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909529Medicaid
NC246253Medicare PIN
NCT64803Medicare UPIN