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Individual

LESLIE N. HEDDLESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1417 S CLIFF AVE, STE 100, SIOUX FALLS, SD 57105-1063
(605) 322-8937
(605) 322-8938
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
3758
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025040700
NE
01
1639240732
ARAZ/AMERICA'S PPO
SD
05
1639240732
IA
01
1658
MIDLANDS CHOICE
SD
01
283761009502
PREFERRED ONE
SD
01
370624200
DEPT OF LABOR
SD
01
3758
SD STATE LICENSE
SD
01
4993265
BLUE CROSS
SD
01
57105AD06
WPS TRICARE
SD
05
6200053
SD
01
658C9HE
BLUE CROSS
MN
05
774219300
MN
01
924114229808
PRIMEWEST
MN
01
G54151
CALIFORNIA STATE LICENSE
CA
01
HP30795
HEALTHPARTNERS
SD
Enumeration date
11/11/2006
Last updated
10/10/2018
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