Individual
MS. ERIN E LEESEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
482 S LANDMARK AVE, BLOOMINGTON, IN 47403-5000
(812) 355-3299
(812) 355-3290
Mailing address
600 S EAGLESON AVE, BLOOMINGTON, IN 47405-5000
(812) 855-4011
(812) 355-4628
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003470A
IN
207Q00000X
Family Medicine Physician
2007-01098
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200941160
—
IN
Enumeration date
04/11/2007
Last updated
06/03/2022
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