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Individual

DR. JOHN T LESLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
675 HIGHWAY 62 E, MOUNTAIN HOME, AR 72653-3207
(870) 508-7600
(870) 508-7609
Mailing address
675 HIGHWAY 62 E, MOUNTAIN HOME, AR 72653-3207
(870) 508-7600
(870) 508-7609

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-5469
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
166793001
AR
01
5H064
BLUECROSS BLUESHIELD
AR
Enumeration date
06/16/2006
Last updated
04/01/2019
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