STUART S LEICHT (NPI# 1013902907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013902907 |
| Entity Type | Individual |
| Full Name | STUART S LEICHT |
| Credential | M.D. |
| Practice Address |
2898 Boones Creek Rd Ste 105 Johnson City TN 37615-4976 |
| Practice Telephone | 4232620112 |
| Mailing Telephone | 4232620112 |
| Mailing Fax Number | 4234336060 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2020-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD17098 | TN | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
MD17098 | TN | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD17098 | TN | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | MD17098 | TN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2898 Boones Creek Rd Ste 105, Johnson City, TN 376154976 | 4232620112 |
| Street Address |
2898 BOONES CREEK RD STE 105 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37615-4976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975106 | East Tennessee Medical and Surgical Dermatology | Clinic/Center | 2898 Boones Creek Rd Ste 105, Johnson City, TN 37615-4976 | 2020-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467968859 | Outreach Clinics Unlimited Pllc | Dermatology | 1627 Old Gray Station Rd Ste 4, Johnson City, TN 37615-4193 | 2017-12-20 |
| 1538575709 | Emily Dell | Dermatology | 1009 N State of Franklin Rd, Johnson City, TN 37604 | 2014-07-08 |
| 1790096196 | Robert George Egbers | Dermatology | 302 Reynolds Rd Ste A, Johnson City, NY 13790-1308 | 2010-06-30 |
| 1083868087 | Arthur Michael Coddington Jr. | Dermatology | 394 Main Street, Johnson City, NY 13790-1914 | 2008-11-05 |
| 1225160807 | William Alan Schueller | Dermatology | 1026 Somerset Dr, Johnson City, TN 37604-2958 | 2007-03-10 |
| 1427128511 | Dermatolgy & Dermatologic Surgery PC | Dermatology | 1021 W Oakland Dr, Suite 102, Johnson City, TN 37604-0000 | 2006-11-08 |
| 1639160815 | James Richard Risney | Dermatology | 1021 W Oakland Ave, Suite 102, Johnson City, TN 37604-2191 | 2005-11-04 |
| 1861482465 | Timothy Lee Gardner | Dermatology | 1009 N State of Franklin Access Rd, Johnson City, TN 37604-3693 | 2005-10-25 |
| 1447253653 | George Beverly Winton | Dermatology | 1009 N State of Franklin Access Road, Johnson City, TN 37604-3693 | 2005-05-23 |
| 1609145622 | Medical Education Assistance Corporation | Dermatology | 329 N State of Franklin Rd, Johnson City, TN 37604 | 2011-12-20 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37615 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.