# JEFFREY LEIDER MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OnHealthcare Audiology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902175318
- **Authorized official:** DR. JEFFREY S LEIDER MD (CLINICAL DIRECTOR)
- **Authorized official phone:** (248) 528-1981

## Contact information

- **Practice address:** 35 AUGUSTA AVE, FT WRIGHT, KY 41011-3603
- **Practice address phone:** (248) 528-1981
- **Practice address fax:** (248) 528-1981
- **Mailing address:** 1200 KIRTS BLVD, SUITE 200, TROY, MI 48084-4899
- **Mailing address phone:** (248) 528-1981
- **Mailing address fax:** (248) 528-2963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 0548 | KY | Yes |

## Other

- **Enumeration date:** 12/14/2011
- **Last updated:** 10/21/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100193700 | — | KY |