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Individual

MARK C LEESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24 MORRIS RD, SUITE 2, SHELBY, OH 44875-1170
(419) 347-4177
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
(614) 544-6356

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
042998
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0061878
OH
Enumeration date
01/04/2006
Last updated
01/25/2022
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