Individual
LESLIE H GLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
606 WILSON CREEK RD, LAWRENCEBURG, IN 47025-1095
(812) 496-8780
(812) 537-5826
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(812) 496-8780
(812) 537-5826
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01050774A
IN
208000000X
Pediatrics Physician
01050774A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000355511
ANTHEM IN OH KY
—
05
—
200226980
—
IN
01
—
2518026
UNITED HEALTHCARE
—
01
—
P00206914
RAILROAD MEDICARE
—
Enumeration date
03/14/2006
Last updated
02/28/2023
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