Organization
RIVIERA PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD K LEEDY M.D. (DR OWNER)
(317) 297-3507
Entity
Organization
Contact information
Practice address
4115 OFFICE PLAZA BLVD, INDIANAPOLIS, IN 46254-2408
(317) 297-3507
(317) 290-2557
Mailing address
4115 OFFICE PLAZA BLVD, INDIANAPOLIS, IN 46254-2408
(317) 297-3507
(317) 290-2557
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01021195A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083791
BLUE CROSS
IN
Enumeration date
04/06/2007
Last updated
08/22/2020
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