Leonard, Jack J.

Leonard, Jack J. is an individual health care provider with primary practice located at 122 W 7Th Ave Ste 110, Spokane WA 99204-2349. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Leonard, Jack J. can be contacted via phone (509) 456-0262.

Contact Information

Primary practice address
122 W 7Th Ave Ste 110 Spokane WA 99204-2349
Phone: (509) 456-0262
Fax: (509) 462-5059
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X MD00018141 Washington
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X M-8957 Idaho

Profile Details

NPI number 1861490732
LBN Legal business name Leonard, Jack J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Jan 12th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861490732 NPPES
Idaho MEDICAID 004173400
Idaho Other 11107621
Idaho Other G8878300
Idaho Other G8871041
Idaho MEDICAID 1599901

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