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Organization

JEFFREY LEIDER MD PLLC

Active
Other names
OnHealthcare Audiology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY S LEIDER MD (CLINICAL DIRECTOR)
(248) 528-1981
Entity
Organization

Contact information

Practice address
35 AUGUSTA AVE, FT WRIGHT, KY 41011-3603
(248) 528-1981
(248) 528-1981
Mailing address
1200 KIRTS BLVD, SUITE 200, TROY, MI 48084-4899
(248) 528-1981
(248) 528-2963

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
0548
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100193700
KY
Enumeration date
12/14/2011
Last updated
10/21/2015
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