Individual
LEONARD LEVEILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4480 W SPENCER ST, APPLETON, WI 54914-9106
(920) 738-4800
(920) 738-5749
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37221
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001345003
MEDICARE PTAN
WI
05
—
32174700
—
WI
Enumeration date
06/18/2006
Last updated
03/14/2012
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