Provider Demographics
NPI:1144265992
Name:LUINSTRA, LESLIE M (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:M
Last Name:LUINSTRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9102
Practice Address - Street 1:720 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8778
Practice Address - Country:US
Practice Address - Phone:316-284-5155
Practice Address - Fax:316-284-5110
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS047731OtherBCBS
KS16937OtherCOVENTRY
KS100952OtherHPK
KS12149377OtherMULTIPLAN
KS2380OtherPHS
KS047731OtherBCBS
KS2380OtherPHS