Individual
THOMAS SCOTT LEUPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5357
Mailing address
11 MAJESTIC OAKS RD, ELDON, MO 65026-5518
(815) 354-7476
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2006010480
MO
Other
Enumeration date
05/23/2006
Last updated
10/06/2007
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