Individual
DR. J TIMOTHY LEAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E IDAHO ST, SUITE 200, BOISE, ID 83712-6267
(208) 381-7312
(208) 381-7313
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-7312
(208) 381-7313
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
M7792
ID
Other
Enumeration date
06/15/2006
Last updated
04/22/2011
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