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General NPI Number Information
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NPI Number | 1821238171
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Entity Type | Individual
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Provider Name | ANN LEBECK MD
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Gender | Female
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 3353 CANYON DE FLORES SUITE A
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City | SIERRA VISTA
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State | AZ
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Zip | 85650
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Country | US
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Telephone | 808-321-0567
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Fax |
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Provider Business Mailing Address
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Address Line | 3533 CANYON DE FLORES STE A
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City | SIERRA VISTA
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State | AZ
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Zip | 85650-5366
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Country | US
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Telephone | 808-321-0567
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 16920
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 57360
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 57.013093
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License Number State | OH
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