Individual
DR. LEON R GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
016351
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00094212G
—
GA
01
—
02874
COVENTRY PPO
GA
01
—
180021438
RR MEDICARE
GA
01
—
294526
WELLCARE
GA
01
—
4278685
AETNA
GA
01
—
442816
BCBS
GA
01
—
474665
AETNA HMO
GA
01
—
5241
COVENTRY HMO
GA
01
—
582209517
WORK COMP
GA
01
—
890558
UHC
GA
Enumeration date
06/30/2005
Last updated
11/15/2013
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