Individual
DR. WILLIAM E LEADINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1330 CARTER AVE, STE 3, ASHLAND, KY 41101-7544
(606) 329-1258
(606) 329-1258
Mailing address
PO BOX 2005, STE 3, ASHLAND, KY 41105-2005
(606) 329-8672
(606) 329-1258
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
748-DT
KY
152WS0006X
Sports Vision Optometrist
748-DT
KY
152WV0400X
Vision Therapy Optometrist
Primary
748-DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000305764
ANTHEM BLUECROSS
KY
01
—
0005282086
AETNA
—
01
—
0149565-001
MEDICAID
WV
01
—
181142
NATIONAL VISION ADMIN.
—
01
—
2202261
UNITED HEALTHCARE
—
01
—
4904360001
OMERC
—
05
—
77903664
—
KY
01
—
DA4299
RAILROAD MEDICARE (GROUP)
—
01
—
KY00748
VISION BENEFITS OF AMER.
—
01
—
P00058622
RAILROAD MEDICARE
—
Enumeration date
08/18/2005
Last updated
12/28/2012
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