Individual
THOMAS B LEECOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,D.P.M.
Contact information
Practice address
409 W BROAD ST, RICHMOND, VA 23220-4220
(804) 643-8667
Mailing address
409 W BROAD ST, RICHMOND, VA 23220-4220
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000319
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009302221
—
VA
Enumeration date
12/06/2006
Last updated
10/21/2011
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