| Doctor Name: | DR. LEON WADDY |
| NPI Number: | 1710970421 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | R-2830 |
| Business Practice Address: | 328 Kittle Rd Forrest City, AR - 723352960 |
| Business Phone Number: | 8706330220 |
| Business Fax Number: | 8706330212 |
| Mailing Address: | Po Box 603, MARIANNA |
| State: | AR |
| Postal Code: | 723600603 |
| Phone Number: | 8702952076 |
| Fax Number: | |
| NPI Enumeration Date: | 08/27/2005 |
| NPI Last Update Date: | 08/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | R-2830 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |