| Leap Medical Services Llc | |
|
22375 Troon Dr Athens AL 35613-8138 | |
| (337) 408-0797 | |
| (337) 943-0846 |
| Full Name | Leap Medical Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 22375 Troon Dr, Athens, Alabama |
| Authorized Official Name and Position | Matthew D. Hanserd (OWNER) |
| Authorized Official Contact | 3374080797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leap Medical Services Llc 1509 Dulles Dr Lafayette LA 70506-3718 Ph: (337) 408-0797 | Leap Medical Services Llc 22375 Troon Dr Athens AL 35613-8138 Ph: (337) 408-0797 |
| NPI Number | 1346897550 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 03/11/2020 |
| Medicare PECOS PAC ID | 2961834189 |
|---|---|
| Medicare Enrollment ID | O20191108002083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346897550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew Hanserd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942524434 PECOS PAC ID: 0345489563 Enrollment ID: I20150323002283 |
| Provider Name | Christina Vail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073983995 PECOS PAC ID: 3274838784 Enrollment ID: I20160222001315 |
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