Individual
JOEL MARTIN LEIBSOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19101 E VALLEY VIEW PKWY, SUITE D, INDEPENDENCE, MO 64055-6904
(816) 836-8166
(816) 836-3160
Mailing address
19101 E VALLEY VIEW PKWY, SUITE D, INDEPENDENCE, MO 64055-6904
(816) 836-8166
(816) 836-3160
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0417025
KS
207W00000X
Ophthalmology Physician
18621
IA
207W00000X
Ophthalmology Physician
Primary
R7571
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06574019
BLUE CROSS BLUE SHIELD
—
Enumeration date
04/21/2006
Last updated
05/07/2012
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