Individual
DR. JEFFREY LOUIS LEABERRY
Active
Individual
DR. JEFFREY LOUIS LEABERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANESTHESIOLOGIST
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
17790
WV
207L00000X
Anesthesiology Physician
Primary
35.080552
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721141
WV BLUE CROSS PROVIDER #
WV
05
—
0060808000
—
WV
01
—
440585258-00
WV WORKERS COMP PROVIDER
WV
Enumeration date
11/09/2006
Last updated
03/29/2018
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