Individual
LESLIE Y SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 776-8912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35499
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64002462
—
KY
Enumeration date
06/27/2005
Last updated
02/04/2011
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