Individual
MRS. LESLIE LUIDA BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEDIATRICS MD
Contact information
Practice address
8595 PICARDY AVE, STE 200, BATON ROUGE, LA 70809-3670
(225) 767-5520
(225) 767-4934
Mailing address
PO BOX 14782, BATON ROUGE, LA 70898
(225) 767-5520
(225) 767-4934
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12994R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2211737
AETNA (HOM)
LA
01
—
5402322
AETNA (POS)
LA
Enumeration date
07/24/2006
Last updated
07/08/2007
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