Individual
LARRY M LEADBETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2857
Mailing address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2857
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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