Leatham, Kinnard J
Leatham, Kinnard J is an individual health care provider with primary practice located at 545 N River St #130, Wilkes Barre PA 18702-2600. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Leatham, Kinnard J can be contacted via phone (570) 552-2760.Contact Information
Primary practice address
545 N River St #130
Wilkes Barre PA 18702-2600
Phone: (570) 552-2760
Fax: (570) 552-2765
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MA079207 | New Jersey |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | MA076933 | New Jersey |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD418397 | Pennsylvania |
Profile Details
| NPI number | 1780630392 |
|---|---|
| LBN Legal business name | Leatham, Kinnard J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Dec 5th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780630392 | NPPES |
| New Jersey | MEDICAID | 0039381 | |
| New Jersey | Other | 1087117 | |
| New Jersey | MEDICAID | 0018088940006 | |
| New Jersey | Other | 2404983000 | |
| New Jersey | Other | P3624813 |
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