Individual
DR. JAMES C LEADINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., PSC
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
KY
05
—
0149556000
—
WV
01
—
1432032
UNITED MINE WORKERS H&R
KY
01
—
610980551
TAX ID
KY
05
—
77007318
—
KY
01
—
P00134006
RAILROAD MEDICARE
KY
Enumeration date
10/10/2005
Last updated
02/07/2013
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