Individual
LESLIE J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1465 S GRAND BLVD RM 2717, 1465 SOUTH GRAND BLVD, RM 2717, SAINT LOUIS, MO 63104-1003
(314) 577-5634
(314) 577-5616
Mailing address
1465 S GRAND BLVD RM 2717, SSM HEALTH CARDINAL GLENNON CHILDREN'S HOSPITAL, SAINT LOUIS, MO 63104-1003
(314) 577-5634
(314) 577-5616
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2020020189
MO
Other
Enumeration date
03/24/2017
Last updated
03/11/2021
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