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Individual

JOSEPH SCOTT LEITHOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4235 INDIAN RIPPLE ROAD, STE 210, BEAVERCREEK, OH 45440
(937) 427-9202
(937) 427-9671
Mailing address
4235 INDIAN RIPPLE ROAD, STE 210, BEAVERCREEK, OH 45440
(937) 427-9202
(937) 427-9671

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35070285
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000012299Z
ANTHEM
01
0122804
UNITED HEALTH CARE
05
0248397
OH
01
080162406
MEDICARE RAILROAD
OH
01
311715256001
TRICARE
01
311715256026
CARESOURCE
01
D70285
CHOICE CARE
01
DB1884
MEDICARE PALMETTO GBA
OH
01
OC04048
NATIONWIDE
Enumeration date
08/31/2006
Last updated
07/01/2014
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