Individual
GARY LEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 LAWRENCE DR, DE PERE, WI 54115-9108
(920) 983-3220
Mailing address
1800 LAWRENCE DR, DE PERE, WI 54115-9108
(920) 983-3220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37143
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37143
LICENSE
WV
Enumeration date
12/06/2005
Last updated
03/04/2014
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