| Doctor Name: | MR. TIMOTHY RICHARD LEUENBERGER |
| NPI Number: | 1851623730 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | 3707P |
| Business Practice Address: | 101 Jb Shannon Dr Suite A Flemingsburg, KY - 410419812 |
| Business Phone Number: | 6062090020 |
| Business Fax Number: | 6062090022 |
| Mailing Address: | 1350 Flemingsburg Rd, MOREHEAD |
| State: | KY |
| Postal Code: | 403511810 |
| Phone Number: | 6067841115 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2010 |
| NPI Last Update Date: | 01/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3707P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |