Basic Information
Provider Information
NPI: 1043236367
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARAYANNOPOULOS
FirstName: LEONIDAS
MiddleName: N
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7425 FORSYTH
Address2: C B 8221
City: SAINT LOUIS
State: MO
PostalCode: 631052161
CountryCode: US
TelephoneNumber: 3143628983
FaxNumber: 3143628987
Practice Location
Address1: 660 S EUCLID AVE
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3143628983
FaxNumber: 3143628987
Other Information
ProviderEnumerationDate: 07/14/2006
LastUpdateDate: 01/09/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X110719MOY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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