Leavell, Keith James
Leavell, Keith James is an individual health care provider with primary practice located at 1200 6Th Ave N Centracare Clinic, Saint Cloud MN 56303-2735. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Leavell, Keith James can be contacted via phone (320) 252-5131.Contact Information
Primary practice address
1200 6Th Ave N Centracare Clinic
Saint Cloud MN 56303-2735
Phone: (320) 252-5131
Fax: (320) 240-2118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 34628 | Minnesota |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | 34628 | Minnesota |
Profile Details
| NPI number | 1184606311 |
|---|---|
| LBN Legal business name | Leavell, Keith James |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Aug 14th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184606311 | NPPES |
| Other | 1011246 | PREFERRED ONE | |
| Other | 597042 | PREFERRED ONE | |
| Other | 112115 | PREFERRED ONE | |
| Other | COMP | PREFERRED ONE | |
| Other | 110122640 | PREFERRED ONE | |
| Other | 597042 | PREFERRED ONE | |
| Other | 928880500 | PREFERRED ONE | |
| Other | COMP | PREFERRED ONE | |
| Other | COMP | PREFERRED ONE | |
| Other | HP10860 | PREFERRED ONE | |
| Other | COMP | PREFERRED ONE | |
| Other | 4800134 | PREFERRED ONE | |
| Other | C11369 | PREFERRED ONE | |
| Other | 27T22LE | PREFERRED ONE | |
| Other | 2114069 | PREFERRED ONE |
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