Individual
LARRY M LEADBETTER
Active
Individual
LARRY M LEADBETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36604
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402550
MEDICA #
MN
01
—
0402551
MEDICA #
MN
01
—
0403068
MEDICA #
MN
01
—
110073027
RR MEDICARE #
MN
01
—
11721
NDBS #
MN
01
—
167284
UCARE #
MN
01
—
2M786LE
MNBS #
MN
05
—
692765300
—
MN
01
—
899037
AMERICA'S PPO/ARAZ #
MN
01
—
8F746LE
MNBS #
MN
01
—
8F747LE
MNBS #
MN
01
—
DA9041015687
PREFERRED ONE #
MN
01
—
HP19540
HEALTHPARTNERS #
MN
01
—
MN100005
LHS/BANNERHEALTH #
MN
Enumeration date
06/10/2006
Last updated
08/22/2011
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