Individual
DR. STEPHEN DAVID LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3815 W RICKENBACKER ST, SUITE 213, BOISE, ID 83705
(208) 901-4493
(208) 917-8605
Mailing address
3815 W RICKENBACKER ST, SUITE 213, BOISE, ID 83705
(208) 901-4493
(208) 917-8605
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
038288
GA
208600000X
Surgery Physician
038288
GA
2086S0129X
Vascular Surgery Physician
Primary
M-12611
ID
Other
Enumeration date
12/14/2006
Last updated
05/23/2023
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