Individual
STUART S LEICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2898 BOONES CREEK RD STE 105, JOHNSON CITY, TN 37615-4976
(423) 262-0112
Mailing address
2898 BOONES CREEK RD STE 105, JOHNSON CITY, TN 37615-4976
(423) 262-0112
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD17098
TN
207NP0225X
Pediatric Dermatology Physician
MD17098
TN
207NS0135X
Procedural Dermatology Physician
MD17098
TN
207R00000X
Internal Medicine Physician
MD17098
TN
Other
Enumeration date
09/16/2005
Last updated
04/03/2020
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