Thornton, Leia Marlene

Thornton, Leia Marlene is an individual health care provider with primary practice located at 4749 Berry Blvd , Montgomery AL 36106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Thornton, Leia Marlene can be contacted via phone (334) 271-0280.

Contact Information

Primary practice address
4749 Berry Blvd Montgomery AL 36106
Fax: (334) 271-1918
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA435 Alabama

Profile Details

NPI number 1376597518
LBN Legal business name Thornton, Leia Marlene
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated May 22nd, 2008 - about 16 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 1376597518 NPPES
Mississippi MEDICAID 06437010
Mississippi Other 51533432
Mississippi MEDICAID 1504297
Mississippi MEDICAID 009936221

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