Individual
DR. LEANN MARIE STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
411 W TIPTON ST, SEYMOUR, IN 47274-2363
(812) 522-0144
(812) 522-0466
Mailing address
411 W TIPTON ST, SEYMOUR, IN 47274-2363
(812) 522-0144
(812) 522-0466
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01066073
IN
2085R0202X
Diagnostic Radiology Physician
Primary
01066073A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000712370
ANTHEM
IN
05
—
200989190
—
IN
Enumeration date
07/01/2008
Last updated
01/22/2026
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