Individual
DR. JOHN WILLIAM LEIDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.-PH.D.
Contact information
Practice address
1249 15TH STREET, DEPARTMENT OF MEDICINE, JC EDWARDS SCHOOL OF MEDICINE, HUNTINGTON, WV 25701
(304) 691-1050
(304) 429-0290
Mailing address
1249 15TH ST DEPT MED, HUNTINGTON, WV 25701-3662
(304) 691-1050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14767
WV
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
14767
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003532
—
WV
Enumeration date
08/21/2006
Last updated
12/30/2021
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