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DR. JACK L LIEBO M.D.
NPI 1649255464
Family Medicine in St Louis Park, MN

Active since December 14, 2005
3931 LOUISIANA AVE S, STE E400, ST LOUIS PARK, MN 55426(952) 993-3230 Get Directions Write a Review

NPPES record last updated: March 2, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack L Liebo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK L LIEBO M.D. (NPI 1649255464) is an individual family medicine provider in St Louis Park, Minnesota, licensed in Minnesota (24488) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1649255464
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JACK L LIEBOCredential: M.D.
Location Address3931 LOUISIANA AVE S, STE E400St Louis Park, MN 55426-4375
Mailing Address3800 Park Nicollet Blvd, CredentialingSt Louis Park, MN 55416-2527
Phone(952) 993-3230
Sole ProprietorNo
Enumeration DateDecember 14, 2005
Last NPPES UpdateMarch 2, 2012
✔ NPI 1649255464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 24488
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3931 LOUISIANA AVE S, St Louis Park, MN 55426
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Other Identifiers 1

Medicare UPINA93961

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMILLE ASHLEY SCHWARZROCK NP-C
Nurse Practitioner
3931 LOUISIANA AVE S
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3230
WILL C JENSEN MD
Internal Medicine (Pulmonary Disease)
3931 LOUISIANA AVE S
SAINT LOUIS PARK, MN 55426
Hennepin County (952) 993-3123
LESLIE PRATT
Obstetrics & Gynecology (Maternal & Fetal Medicine)
3931 LOUISIANA AVE S, STE E111
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-5900
AMANDA J CALVIN MD
Internal Medicine (Pulmonary Disease)
3931 LOUISIANA AVE S
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3230
MARI M UUTALA LPC
Counselor (Professional)
3931 LOUISIANA AVE S
SAINT LOUIS PARK, MN 55426
Hennepin County (952) 993-3248
BROOKE RAEANNE VOGT PHYSICIAN ASSISTANT
Physician Assistant
3931 LOUISIANA AVE S
SAINT LOUIS PARK, MN 55426
Hennepin County (952) 993-3180
DORY L NEUROCK NP
Nurse Practitioner (Family)
3931 LOUISIANA AVE S
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3123
DR. MEILING HUA PARKER MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
3931 LOUISIANA AVE S
ST LOUIS PARK, MN 55426
Hennepin County (952) 993-3230

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Liebo's NPI number?

The NPI number for Jack Liebo is 1649255464. It was assigned to this individual provider in the NPPES registry on December 14, 2005.

Where is Jack Liebo located?

Jack Liebo practices at 3931 Louisiana Ave S Ste E400, St Louis Park, MN 55426. The listed phone number is (952) 993-3230.

What is Jack Liebo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Jack Liebo was last updated on March 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.