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Contact Information

COREY T LEACH, OD
2826 E BASELINE RD # 101
MESA, AZ85204-7282
 Phone: 480-626-8925
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Corneal and Contact Management

152WC0802X 41 Optometry
 

Sports Vision

152WS0006X 41 Optometry
Indicates primary specialty

NPI Profile & details for COREY T LEACH · (Male)

NPI # 1427658921
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 10/26/2020
Last updated 04/04/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # OPT-002774
  • KY License # 2209DT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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