Provider Demographics
NPI:1639699242
Name:LEUNGSUWAN, KANJIT (MD)
Entity type:Individual
Prefix:
First Name:KANJIT
Middle Name:
Last Name:LEUNGSUWAN
Suffix:
Gender:M
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 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-547-3456
Mailing Address - Fax:607-547-6612
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-0295
Practice Address - Fax:859-323-1256
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-24
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54127208M00000X, 207RC0000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease