Leiva, Jose M
Leiva, Jose M is an individual health care provider with primary practice located at 5471 W Waterford Ln , Appleton WI 54913-8510. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Leiva, Jose M can be contacted via phone (920) 731-7445.Contact Information
Primary practice address
5471 W Waterford Ln
Appleton WI 54913-8510
Phone: (920) 731-7445
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 44271 | Wisconsin |
Profile Details
| NPI number | 1962496760 |
|---|---|
| LBN Legal business name | Leiva, Jose M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2005 |
| Last updated | Feb 29th, 2024 - about 7 months 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 | 1962496760 | NPPES |
| Wisconsin | MEDICAID | 34359400 |
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