Individual
EDWARD C LEICHNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
180 OLD HICKORY BLVD, JACKSON, TN 38305-2562
(731) 661-2750
(731) 664-6817
Mailing address
180 OLD HICKORY BLVD, JACKSON, TN 38305-2562
(731) 661-2750
(731) 664-6817
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO1128
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4110174
BLUE CROSS
TN
Enumeration date
07/06/2006
Last updated
11/14/2023
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