Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kinnard J Leatham, MD

Individual provider Surgery Physician · NPI 1780630392

Kinnard J Leatham, MD is a General Surgery in Wilkes Barre, Pennsylvania. Graduated from Albany Medical College of Union University in 1992, 34 years ago. Practices with Penn State Health Medical Group LLC, a 711-clinician group and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
34
Trained at
Albany Medical College of Union University
Licensed in
NJ, PA
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

545 N River St #130
Wilkes Barre, PA 18702-2600
Phone: (570) 552-2760
Fax: (570) 552-2765
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence MD418397 (PA)
Surgery Physician Taxonomy 208600000X · Licence MA079207 (NJ)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence MA076933 (NJ)

Record details

NPI number1780630392
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 25, 2006
Last updated in NPPESDecember 5, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduated 1992 (34 years in practice)
Group practice Penn State Health Medical Group Llc — 711 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wilkes Barre