Provider Demographics
NPI:1558469858
Name:LEIGHTON, JOHN (MD)
Entity type:Individual
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First Name:JOHN
Middle Name:
Last Name:LEIGHTON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:952-883-6391
Mailing Address - Fax:952-883-9662
Practice Address - Street 1:9825 HOSPITAL DR
Practice Address - Street 2:SUITE 125
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4479
Practice Address - Country:US
Practice Address - Phone:763-581-9220
Practice Address - Fax:763-581-9221
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-07-27
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Provider Licenses
StateLicense IDTaxonomies
MN14941207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND81321Medicare UPIN