| Doctor Name: | DR. JEROME LEAHEY |
| NPI Number: | 1104828557 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01019789A |
| Business Practice Address: | 622 E Elm St Union City, OH - 453901722 |
| Business Phone Number: | 9379687416 |
| Business Fax Number: | |
| Mailing Address: | Po Box 452, UNION CITY |
| State: | OH |
| Postal Code: | 45390 |
| Phone Number: | 7659644100 |
| Fax Number: | 7659644300 |
| NPI Enumeration Date: | 08/15/2005 |
| NPI Last Update Date: | 09/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01019789A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |