Leistikow, Corrine

Leistikow, Corrine is an individual health care provider with primary practice located at 1001 Noble St , Fairbanks AK 99701-4922. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Leistikow, Corrine can be contacted via phone (907) 459-3511.

Contact Information

Primary practice address
1001 Noble St Fairbanks AK 99701-4922
Phone: (907) 459-3511
Fax: (907) 459-3588
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 2487 Alaska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2487 Alaska

Profile Details

NPI number 1417922774
LBN Legal business name Leistikow, Corrine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Mar 7th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417922774 NPPES
Alaska MEDICAID 1007182

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