Provider Demographics
NPI:1366466203
Name:BATEMAN, LEONARD WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:WAYNE
Last Name:BATEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19501 E US HIGHWAY 40
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5463
Mailing Address - Country:US
Mailing Address - Phone:816-795-5000
Mailing Address - Fax:816-795-5001
Practice Address - Street 1:19501 E US HIGHWAY 40
Practice Address - Street 2:SUITE B
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5463
Practice Address - Country:US
Practice Address - Phone:816-795-5000
Practice Address - Fax:816-795-5001
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10272015OtherBLUE CROSS BLUE SHIELD
MO14082OtherCOVENTRY
MO5340600OtherAETNA
MO10272015OtherBLUE CROSS & BLUE SHIELD
MO4400233OtherUNITED HEALTHCARE
MO4400233OtherUNITED HEALTHCARE
MO5340600OtherAETNA