Individual
LEONARD J KIBILOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 CALIFORNIA ROAD, SUITE A, ELKHART, IN 46514-1228
(574) 264-0791
(574) 262-9650
Mailing address
2310 CALIFORNIA ROAD, SUITE A, ELKHART, IN 46514-1228
(574) 264-0791
(574) 262-9650
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01040247A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100197730A
—
IN
Enumeration date
07/15/2006
Last updated
02/02/2010
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