Organization
WEST LESLIE ER PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS RONAN (VICE PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
130 MEDICAL CIRCLE, NASHVILLE, AR 71852-4015
(870) 845-8003
(870) 845-4178
Mailing address
13737 NOEL RD, STE 1600, DALLAS, TX 75240-1331
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165376002
—
AR
01
—
5F548
BLUE SHIELD
AR
Enumeration date
05/09/2006
Last updated
12/24/2013
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