Individual
MR. LEON J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 N PINE ST, BLUE HILL CLINIC, BLUE HILL, NE 68930-5532
(402) 756-2141
(402) 756-2142
Mailing address
102 N PINE ST, BLUE HILL CLINIC, BLUE HILL, NE 68930-5532
(402) 756-2141
(402) 756-2142
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13349
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06154
BLUE CROSS BLUE SHIELD NE
NE
01
—
096853006
MEDICARE PTAN
—
Enumeration date
08/12/2005
Last updated
03/29/2010
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