Individual
DR. LEANNE DETAR NEWBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15604 PINEHURST DR, SUITE 2, BASEHOR, KS 66007-8233
(913) 728-2200
(913) 728-2230
Mailing address
1000 CARONDELET DR, PROVIDER ENROLLMENT/MED STAFF OFC, KANSAS CITY, MO 64114
(816) 943-5744
(816) 943-2767
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0422698
KS
Other
Enumeration date
09/30/2006
Last updated
06/28/2019
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