Individual
MR. STEPHEN HUNT LEATHERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
550 REDMOND RD NW, ROME, GA 30165-1416
(706) 233-8512
(706) 233-8513
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005118
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261031502E
—
GA
05
—
261031502F
—
GA
05
—
261031502G
—
GA
05
—
261031502J
—
GA
Enumeration date
05/11/2006
Last updated
08/24/2011
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