Individual
BENJAMIN WILLIAM LEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-1230
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7101
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01081797A
IN
207P00000X
Emergency Medicine Physician
036148647
IL
207P00000X
Emergency Medicine Physician
2010003231
MO
207P00000X
Emergency Medicine Physician
DR.0056078
CO
207P00000X
Emergency Medicine Physician
Primary
MD61595673
WA
390200000X
Student in an Organized Health Care Education/Training Program
141051
NC
Other
Enumeration date
06/22/2007
Last updated
03/11/2025
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