Individual
DR. DOUGLAS CLINTON LEAVENGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2561 PASS RD, SUITE D, BILOXI, MS 39531-2125
(228) 388-7743
Mailing address
2561 PASS RD, SUITE D, BILOXI, MS 39531-2125
(228) 388-7743
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
11243
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00110476
—
MS
Enumeration date
01/08/2008
Last updated
01/08/2008
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