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Individual

LESLIE WAYNE SMITH

Active
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Individual

LESLIE WAYNE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
023829
CT
2084P0800X
Psychiatry Physician
209098
MA
2084P0800X
Psychiatry Physician
Primary
F2020
TX
2084P0802X
Addiction Psychiatry Physician
023829
CT
2084P0802X
Addiction Psychiatry Physician
209098
MA
2084P0802X
Addiction Psychiatry Physician
F2020
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001238294
CT
05
204374701
TX
01
8X5119
BCBS
TX
01
P00998014
RAILROAD MEDICARE
TX
Enumeration date
09/25/2006
Last updated
08/09/2016
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