Provider Demographics
NPI:1912149261
Name:LEEVER, JOHN D (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:LEEVER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:BUSINESS OPTIONS MEDICAL BILLING
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81402-0308
Mailing Address - Country:US
Mailing Address - Phone:970-765-0818
Mailing Address - Fax:970-497-8410
Practice Address - Street 1:2373 G. ROAD, SUITE 140
Practice Address - Street 2:CANYON VIEW MEDICAL PLAZA
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505
Practice Address - Country:US
Practice Address - Phone:970-644-4345
Practice Address - Fax:970-644-4379
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2019-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK53332085R0202X
MI51010196862085R0202X
CODR.00562052085R0202X
CO00562052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48780065Medicaid
MI1912149261Medicaid
COP01608010OtherRAILROAD WORKERS MEDICARE PTAN FOR DIAGNOSTIC RADIOLOGY ASSOCIATES
CO470004ZP83Medicare PIN
MI1912149261Medicaid