Basic Information
Provider Information
NPI: 1154662856
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COMPTON
FirstName: LEIGH
MiddleName: ANNE
NamePrefix: DR.
NameSuffix:  
Credential: MD PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2: CB 8118
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3143625641
FaxNumber: 3143620369
Practice Location
Address1: 4320 FOREST PARK AVE
Address2: DEPT PATHOLOGY, STE 212
City: SAINT LOUIS
State: MO
PostalCode: 631082979
CountryCode: US
TelephoneNumber: 3143625641
FaxNumber: 3143620369
Other Information
ProviderEnumerationDate: 03/06/2013
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ND0900X2017031165MON Allopathic & Osteopathic PhysiciansDermatologyDermatopathology
207ZP0102X2017031165MOY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

ID Information
IDTypeStateIssuerDescription
20004634505MO MEDICAID


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