Provider Demographics
NPI:1821084146
Name:LEEKE, ELLEN LOUISE (DO)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:LOUISE
Last Name:LEEKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ELLEN
Other - Middle Name:LOUISE
Other - Last Name:PARTRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:12 THE CROFTERS
Mailing Address - Street 2:
Mailing Address - City:STRETHAM
Mailing Address - State:CAMBRIDGESHIRE
Mailing Address - Zip Code:CB6 3NF
Mailing Address - Country:GB
Mailing Address - Phone:01144135-364-8962
Mailing Address - Fax:
Practice Address - Street 1:FAMILY PRACTICE, 48TH MDG/MDOS/SGOPF
Practice Address - Street 2:RAF LAKENHEATH
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09464
Practice Address - Country:GB
Practice Address - Phone:01144163-852-8010
Practice Address - Fax:01144163-852-8022
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002228A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice