Individual
DR. LESLEY WILCOXSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1020 STAGSHAW LN, KINGSPORT, TN 37660-1077
(423) 246-8082
Mailing address
1020 STAGSHAW LN, KINGSPORT, TN 37660-1077
(423) 246-8082
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101240639
VA
207P00000X
Emergency Medicine Physician
2007-00581
NC
207P00000X
Emergency Medicine Physician
Primary
36231
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010186366
—
VA
Enumeration date
06/16/2006
Last updated
11/16/2012
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