MR. PETER JOHN LEICHTNAM


Address: 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660
Phone: 5099942105

MR. PETER JOHN LEICHTNAM (NPI# 1164072187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164072187
Entity Type Individual
Full Name MR. PETER JOHN LEICHTNAM
Practice Address 1200 W Ironwood Dr Ste 309
Coeur D Alene
ID 83814-2660
Practice Telephone 5099942105
Mailing Telephone 5099942105
Enumeration Date 2019-09-12
Last Update Date 2019-09-12
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center ID Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
10905 E Montgomery Dr Ste 4, Spokane Valley, WA 992066606 5099942105 5098926924
1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 838142660 5099942105

Office Location

Street Address 1200 W IRONWOOD DR STE 309
City COEUR D ALENE
State ID
Zip Code 83814-2660

Providers in the same location

NPI Name Taxonomy Address Enumeration
1952951329 American Mobile Drug Testing / A Drug Free Alliance Clinic/Center 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 2019-09-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477162675 Dehra Mcfaddan Social Worker 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 2020-07-24
1043838634 Yendi Labelle Nurse Practitioner 1115 N Ironwood Drive, Coeur D'alene, ID 83814 2020-07-09
1295353217 Cultivation, LLC Counselor 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 2020-07-07
1306487517 Northwest Integrated Health, LLP Clinic/Center 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 2019-09-30
1730740465 Connor Williams Physical Therapist 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 2019-06-24
1912480153 Nadine M Lewis Social Worker 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 2018-09-13
1992208631 Orthopedic Surgery and Sports Orthopaedic Surgery 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 2018-03-08
1346758042 Heather Marie Johnson Counselor 7905 Meadowlark Way, Cda, ID 83814 2018-01-16
1881113413 Brevity Treatment Services Counselor 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 2017-09-14
1366969628 Jennifer La Gina Highfield Massage Therapist 1104 N Ste B, Coeur D Alene, ID 83814 2017-08-28
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912487646 Ideal Option, Pllc Clinic/Center 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 2018-08-21
1760684153 North Star Child Development Center Clinic/Center 1583 W Dalton Ave, Coeur D Alene, ID 83815-8962 2007-06-05
1316574700 Coeur Vitality Pllc Clinic/Center 110 E Wallace Ave, Coeur D Alene, ID 83814-2948 2020-03-25
1952951329 American Mobile Drug Testing / A Drug Free Alliance Clinic/Center 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 2019-09-17
1366099236 Avalon Counseling, LLC Clinic/Center 1250 W Ironwood Dr Ste 303, Coeur D Alene, ID 83814-2682 2019-08-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1992323216 Wolf Pack LLC Clinic/Center 939 S 25th E Ste 115, Ammon, ID 83406-5736 2020-07-13
1831730118 Falls Medical Aesthetics, Pllc Clinic/Center 814 Pancheri Dr, Idaho Falls, ID 83402-3344 2019-10-08
1124674437 Michael J. Moorhouse Inc. Clinic/Center 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 2019-08-13
1093368276 Korena Popp Fnp Medical Services LLC Clinic/Center 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 2019-07-17
1528623915 D & S Works Clinic/Center 5622 W State St, Boise, ID 83703-3010 2019-05-01
1609335090 Hurst Medical Pllc Clinic/Center 1700 Overland Ave Ste 1, Burley, ID 83318 2019-03-15
1801376256 Ideal Option, Pllc Clinic/Center 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 2018-08-15
1649759374 North Canyon Mountain Home Clinic Clinic/Center 840 N 4th E, Mountain Home, ID 83647-2166 2018-08-13
1104316785 Pend Oreille Vision Care Clinic/Center 6132 Highway 2, Priest River, ID 83856 2018-05-18
1114432689 Triton Elite Athletic Medicine Clinic/Center 2392 E Gowen Rd, Boise, ID 83716-6707 2017-12-06
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Competitor

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City COEUR D ALENE
Zip Code 83814

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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