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Individual

DR. LESLI EAREHART FARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-5848
(304) 388-9654
Mailing address
3200 MACCORKLE AVENUE, SUITE B16, CHARLESTON, WV 25304
(304) 388-5848
(304) 388-9654

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2048
WV
208M00000X
Hospitalist Physician
Primary
2048
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810020098
WV
01
P01067355
MEDICARE RAILROAD
WV
Enumeration date
06/27/2008
Last updated
12/18/2015
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