Basic Information
| Provider Information | |||||||||
| NPI: | 1215992201 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRAYBILL | ||||||||
| FirstName: | LEON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 N DUKE ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175445511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2110 HARRISBURG PIKE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443022 | ||||||||
| FaxNumber: | 7175443021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 07/19/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | MD037155E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1417245 | 01 | PA | AETNA - HMO | OTHER | 4662916 | 01 | PA | AETNA - NON HMO | OTHER | 000000145776 | 01 | PA | UNISON | OTHER | 0111009000 | 01 | PA | AMERIHEALTH 65 / IBC | OTHER | P00053719 | 01 | PA | RAILROAD MEDICARE | OTHER | 0011160470005 | 05 | PA | MEDICAID | 15640 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | P002670 | 01 | PA | GATEWAY | OTHER | 000516905 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 50055984 | 01 | PA | CAPITAL BLUE CROSS | OTHER |