Provider Demographics
NPI:1033569231
Name:LECKIE, KATHERIN ELIZA (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERIN
Middle Name:ELIZA
Last Name:LECKIE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:800 E 28TH ST STE H2100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-863-6800
Practice Address - Fax:612-863-6006
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN736442086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery