Eric J Leestma, | |
519 N Halleck, Demotte, IN 46310 | |
(219) 987-7750 | |
(219) 987-5750 |
Full Name | Eric J Leestma |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 46 Years |
Location | 519 N Halleck, Demotte, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700989233 | NPI | - | NPPES |
100209310A | Medicaid | IN | |
36655 | Other | IN | INDIANA HEALTH NETWORK |
000000084931 | Other | IN | ANTHEM BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 02000641A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Pinnacle Hospital | Crown point, IN | Hospital |
Franciscan Health Crown Point | Crown point, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Leestma Medical Clinic, Inc | 1850290263 | 2 |
Rci (wrs), Llc. | 5092624510 | 328 |
Entity Name | Leestma Medical Clinic, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487986451 PECOS PAC ID: 1850290263 Enrollment ID: O20040105000827 |
Mailing Address | Practice Location Address |
---|---|
Eric J Leestma, Po Box 850, Demotte, IN 46310-0850 Ph: (219) 987-7750 | Eric J Leestma, 519 N Halleck, Demotte, IN 46310 Ph: (219) 987-7750 |
Mrs. Cecilia Jean Sampsel, N.P. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 520 Eighth Ave N.e, Demotte, IN 46310 Phone: 219-987-3581 Fax: 219-987-7137 | |
Mr. Jeffrey Glen Huxford, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 520 8th Ave Ne, Demotte, IN 46310 Phone: 219-987-3581 Fax: 219-987-7137 |