MEDICARE: DR. CHRISTI LORRAINE LEACH M.D.

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
1	2084P0800X	Psychiatry Physician	ME114988	FL
2	2084P0805X	Geriatric Psychiatry Physician	ME114988	FL
3	2084P0805X	Geriatric Psychiatry Physician	04-39966	KS

General Provider Information

NPI Number	:	1669671707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTI LORRAINE LEACH M.D.

Provider Business Mailing Address
First Line	:	2200 SW GAGE BLVD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66622-0001
Country	:	US
Telephone Number	:	785-350-3111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 S CLIFTON AVE STE 300
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-2953
Country	:	US
Telephone Number	:	316-858-0550
Fax Number	:	316-858-0596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/21/2022

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