Individual
JEFFREY D LEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
705 RILEY HOSPITAL DR, RR 230, INDIANAPOLIS, IN 46202-5109
(317) 274-2563
(317) 278-3599
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
01042066
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100379290
—
IN
05
—
64882772
—
KY
Enumeration date
09/13/2006
Last updated
02/06/2014
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