Individual
DR. LEON E PAULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
324 10TH AVE, SUITE 175, SALT LAKE CITY, UT 84103-2853
(801) 408-8123
(801) 408-8124
Mailing address
324 10TH AVE, SUITE 175, SALT LAKE CITY, UT 84103-2853
(801) 408-8123
(801) 408-8124
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
157061-8905
UT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
5107
NV
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
ME102290
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000725800
—
FL
01
—
53250
BLUE CROSS BLUE SHIELD
FL
01
—
592-02754
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/14/2005
Last updated
05/04/2012
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