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NPI Code Detail

MEDICARE: MR. ALLEN J LEIMENSTOLL PA-C

MEDICARE: MR. ALLEN J LEIMENSTOLL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1350OK
2363A00000XPhysician AssistantTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457342776
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALLEN J LEIMENSTOLL PA-C
Provider Business Mailing Address
First Line : 600 S MONROE ST
Second Line :
City : ENID
State : OK
Zip : 73701-7211
Country : US
Telephone Number : 580-233-2300
Fax Number : 580-548-1489
Provider Business Practice Location Address
First Line : 600 S MONROE ST
Second Line :
City : ENID
State : OK
Zip : 73701-7211
Country : US
Telephone Number : 580-233-9310
Fax Number : 580-548-1489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 05/26/2026

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