Individual
DANNY LYNN LEATHERWOOD
Active
Individual
DANNY LYNN LEATHERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01057770
IN
2085R0202X
Diagnostic Radiology Physician
35525
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506086
—
TN
05
—
201010540
—
IN
01
—
4141784
BCBS PROVIDER NUMBER
TN
01
—
620864298
TRICARE
—
01
—
P00860880
RAILROAD MEDICARE
IN
Enumeration date
08/31/2006
Last updated
02/18/2021
Update your record
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