Individual
LEAH ASHLEY MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
(662) 328-1507
Mailing address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
(662) 328-1507
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00253
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08681064
—
MS
Enumeration date
01/26/2012
Last updated
05/20/2016
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