Individual
HUGH M LEAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 W 3RD ST, ELK CITY, OK 73644-5146
(405) 439-9688
Mailing address
PO BOX 189, ELK CITY, OK 73648
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
17742
SC
207RG0100X
Gastroenterology Physician
Primary
27215
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200251060A
—
OK
05
—
T17345
—
SC
Enumeration date
06/26/2006
Last updated
08/29/2014
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