Individual
MARK LEATHERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4351 E LOHMAN AVE STE 405, LAS CRUCES, NM 88011-8261
(575) 522-0091
(575) 522-4984
Mailing address
4351 E LOHMAN AVE STE 405, LAS CRUCES, NM 88011-8261
(575) 522-0091
(575) 522-4984
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2006-0321
NM
Other
Enumeration date
07/28/2006
Last updated
02/05/2010
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