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Individual

SCOTT LOSEE LEIFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
7645204-1204
UT

Other

Enumeration date
09/24/2008
Last updated
08/20/2013
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