Individual
DR. KEITH EDWIN LEAP II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(786) 357-9327
Mailing address
PO BOX 602373, CHARLOTTE, NC 28260-2373
(828) 526-1280
(828) 526-1285
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
073593
GA
207P00000X
Emergency Medicine Physician
2015-00392
NC
207P00000X
Emergency Medicine Physician
31330
WV
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
16953
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCR321A
MEDICARE PTAN
NC
01
—
NCR321B
MEDICARE PTAN
NC
01
—
NCR486A194
MEDICARE PTAN
NC
Enumeration date
03/09/2006
Last updated
02/14/2024
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