MEDICARE: LESLIE H ADCOCK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	RN063419NP	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285699298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE H ADCOCK NP

Provider Business Mailing Address
First Line	:	95 COLLIER ROAD, NW
Second Line	:	SUITE 5015
City	:	ATLANTA
State	:	GA
Zip	:	30309-1721
Country	:	US
Telephone Number	:	404-605-5699
Fax Number	:	404-355-4235

Provider Business Practice Location Address
First Line	:	95 COLLIER ROAD, NW
Second Line	:	SUITE 5015
City	:	ATLANTA
State	:	GA
Zip	:	30309-1721
Country	:	US
Telephone Number	:	404-605-5699
Fax Number	:	404-355-4235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	03/09/2011

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