Provider Demographics
NPI:1578667879
Name:BASKIN, LELAND BURLESON (MD)
Entity Type:Individual
Prefix:
First Name:LELAND
Middle Name:BURLESON
Last Name:BASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9-3535 RESEARCH RD, NW
Mailing Address - Street 2:
Mailing Address - City:CALGARY
Mailing Address - State:AB
Mailing Address - Zip Code:T2L2K8
Mailing Address - Country:CA
Mailing Address - Phone:403-770-3758
Mailing Address - Fax:403-770-3296
Practice Address - Street 1:9-3535 RESEARCH RD, NW
Practice Address - Street 2:
Practice Address - City:CALGARY
Practice Address - State:AB
Practice Address - Zip Code:T2L2K8
Practice Address - Country:CA
Practice Address - Phone:403-770-3758
Practice Address - Fax:403-770-3296
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ021355207ZP0102X
TXH3225207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology