Crandall, Leland D

Crandall, Leland D is an individual health care provider with primary practice located at 1020 Lakeshore Dr , Rice Lake WI 54868. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Crandall, Leland D can be contacted via phone (715) 723-8827.

Contact Information

Primary practice address
1020 Lakeshore Dr Rice Lake WI 54868
Phone: (715) 723-8827
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 19667 Wisconsin
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 19667 Wisconsin

Profile Details

NPI number 1467552836
LBN Legal business name Crandall, Leland D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467552836 NPPES
Wisconsin MEDICAID 31575700

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