Thomas J Leavitt, M.D.
Individual provider Active NPI Hematology & Oncology Physician · Sagle, ID
NPI 1528075744 · NPPES record last updated Dec 18, 2007
Key facts
- NPI
- 1528075744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- License
- M-9379 (ID)
- Practice address
- 284 Buck Run
Sagle, ID 83860 - Phone
- (208) 255-7564
- Fax
- (208) 255-7537
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-9379 | ID | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kootenai Health, Inc. | Past | Accepting new patients | |
| Thomas J. Leavitt MD PC | Hematology & Oncology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | M-9379 | ID | Yes |
Addresses
Primary practice location
284 Buck Run
Sagle, ID 83860
Mailing address
284 Buck Run
Sagle, ID 83860
Phone (208) 255-7564
Other providers in Sagle, ID
- Anna L Blackford
- Michelle Lynn Giles
- Brenda Hammond
- Kyle Hoedebecke
- Julie R. Hoyle
- Ovum Medical, LLC
- Leah Jeanne Pollock
- Kristi Sabo
- Sagle Fire District
- Summit Counseling Center, LLC
All providers in Sagle, ID · Hematology & Oncology Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.