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Individual

DR. LESLIE COPELAND DOMINGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1202 S TYLER ST, COVINGTON, LA 70433-2330
(985) 898-4000
(985) 898-4164
Mailing address
PO BOX 54482, NEW ORLEANS, LA 70154-4482
(985) 898-4000
(985) 898-4164

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26181
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08504875
MS
05
1049743
LA
Enumeration date
07/05/2006
Last updated
09/17/2014
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