Dr. Leon Gresham

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DR. LEON GRESHAM

Practice address

100 S Court St
Calhoun, GA 30701-2296

Phone

(706) 629-8266

Fax

(706) 629-8267

NPI assigned

Feb 13, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leon Gresham, O.D.

Title

Owner

Phone

(706) 629-8266

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1801064803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S COURT ST",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307012296",
            "telephone_number": "706-629-8266",
            "fax_number": "706-629-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S COURT ST",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307012296",
            "telephone_number": "706-629-8266",
            "fax_number": "706-629-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LEON GRESHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-629-8266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00005233A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DFCS Region 3 Field Fiscal Services Office
• DFCS-Region 1 Field Fiscal Office
• Elizabeth H. Dial, MS, LPC, NCC
• Jessica Dobash, NP
• Dana Lynn Dockery, LCSW
• Marc Mitchell Dyke, CRNA
• Lacey Eaton
• Ugochukwu Ekpechi
• Ene L Ekpo
• Kathryn Elemento

• Clinic/Center in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.