Organization
JAMES C LEADINGHAM, O.D., PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES C LEADINGHAM O.D. PSC (DOCTOR/OWNER)
(606) 638-4731
Entity
Organization
Contact information
Practice address
112 VINSON BLVD, LOUISA, KY 41230-1155
(606) 638-4731
(606) 638-3523
Mailing address
112 VINSON BLVD, LOUISA, KY 41230
(606) 638-4731
(606) 638-3523
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0731DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000305678
BCBS
—
05
—
0149556000
—
WV
01
—
1432032
UNITED MIN WORKERS H&R
—
01
—
DB8758
RR MEDICARE
—
Enumeration date
10/09/2007
Last updated
08/01/2012
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