Individual
MR. KEVIN JOHN LEFFERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(866) 413-9534
(260) 407-4428
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01078475A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300003404
—
IN
Enumeration date
01/20/2011
Last updated
11/23/2021
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