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Individual

LEON MCTYEIRE JOHNSTON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
217 N BIGELOW RD, HAMPTON, CT 06247-1439
(860) 455-9958
Mailing address
217 N BIGELOW RD, HAMPTON, CT 06247-1439
(860) 455-9958

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD05710
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2077221
MA
05
7008147
RI
Enumeration date
06/27/2005
Last updated
02/23/2012
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