Individual
DR. JOHN G LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 NIZHONI BLVD, BOX 1337, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1310
Mailing address
516 NIZHONI BLVD, BOX 1337, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9396
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000S6962
—
NM
05
—
414566
—
AZ
Enumeration date
07/03/2006
Last updated
10/31/2011
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