Provider Demographics
NPI:1992762447
Name:OMALLEY, LEIGH ANN (DO)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:OMALLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:98 DOCTORS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-4502
Mailing Address - Country:US
Mailing Address - Phone:828-586-8971
Mailing Address - Fax:828-586-4083
Practice Address - Street 1:98 DOCTORS DR
Practice Address - Street 2:STE 200
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-4501
Practice Address - Country:US
Practice Address - Phone:828-586-8971
Practice Address - Fax:828-586-4083
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200100411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129H4Medicaid
NCH38185Medicare UPIN
NC89129H4Medicaid