Individual
DR. LEON MICHAEL CATTOLICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1200 N. BEAVER, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001
(928) 213-6235
(928) 213-6292
Mailing address
450 S WILLARD ST, COTTONWOOD, AZ 86326-6743
(928) 634-5551
(928) 634-5604
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3427
AZ
207Q00000X
Family Medicine Physician
OS-3268-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3427
LICENSE
AZ
05
—
471467
—
AZ
01
—
AC-6555695
D.E.A.
—
Enumeration date
06/22/2005
Last updated
03/16/2017
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