Individual
LESLEY A HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12615 TAYLORSVILLE RD, LOUISVILLE, KY 40299-4452
(502) 261-1595
(502) 261-1590
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 969-6552
(502) 212-1358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40032
KY
208000000X
Pediatrics Physician
40032
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000486608
ANTHEM FOR NCMA TYLER
KY
05
—
200865590
—
IN
01
—
284510500
PAD NMCA TYLER
KY
01
—
50014893
PASSPORT NMCA TYLER
KY
05
—
64125339
—
KY
01
—
P00388569
RAILROAD MEDICARE
KY
Enumeration date
07/13/2006
Last updated
05/24/2022
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