Individual
DR. DONALD B LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
943 MAIN STREET S.W., LOS OJOS PROFESSIONAL BLDG, LOS LUNAS, NM 87031
(505) 865-4812
(505) 865-3767
Mailing address
943 MAIN STREET SW, LOS LUNAS, NM 87031-8748
(505) 865-4812
(505) 865-3767
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
245OP2245
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10007839
LOVELACE HEALTH, SR
NM
01
—
NM00P054
BLUECROSS BLUESHIELD
NM
05
—
NMP2264
—
NM
Enumeration date
07/13/2005
Last updated
03/28/2008
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