Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 19589 | KS |
NPI | 1003851650 |
---|---|
Provider Name | Yoram B Leitner |
First Address | Wichita, KS 67208-0035 |
Second Address | Wichita, KS 67206-3548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000957 | BCBS (01) | KS |
1000082690A | (05) | KS |
12149370 | MULTIPLAN (01) | KS |
16900 | COVENTRY (01) | KS |
200126 | HPK (01) | KS |
525 | PHS (01) | KS |
B68415 | (02) |