Basic Information
| Provider Information | |||||||||
| NPI: | 1609293943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEITWEIN | ||||||||
| FirstName: | KATHRYN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8240 NAAB ROAD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172077503 | ||||||||
| FaxNumber: | 3173382851 | ||||||||
| Practice Location | |||||||||
| Address1: | 8240 NAAB ROAD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172077503 | ||||||||
| FaxNumber: | 3173382851 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2014 | ||||||||
| LastUpdateDate: | 04/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 01080757A | IN | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.