Individual
LESLI P WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 785-3801
Mailing address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 785-3801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005395
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005395
GEORGIA BOARD OF MEDICAL EXAMINERS
GA
Enumeration date
09/12/2008
Last updated
09/12/2008
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