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Individual

ALLEN W LEADBETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
46 WELLS ST, WESTERLY, RI 02891-2924
(401) 596-0174
(401) 596-2266
Mailing address
46 WELLS ST, WESTERLY, RI 02891-2924
(401) 596-0174
(401) 596-2266

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L5016
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010005016RT101
BLUE SHIELD
CT
01
225399
BLUE SHIELD
RI
05
9002352
RI
Enumeration date
08/15/2006
Last updated
12/26/2007
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