Individual
KERRY D LEICHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1751 ERICKSON AVE, HARRISONBURG, VA 22801-8555
(540) 433-3344
(540) 433-0031
Mailing address
5894 THOMPSON RD, HARRISONBURG, VA 22802-0614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101052233
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025670
ANTHEM ID
VA
01
—
142717
SOUTHERN HEALTH ID
VA
Enumeration date
08/15/2005
Last updated
07/08/2007
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