MEDICARE: DR. LESLIE MICHELE JAMES DMD

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	122300000X	Dentist	6940	KY
2	122300000X	Dentist	12010820A	IN

General Provider Information

NPI Number	:	1649392820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE MICHELE JAMES DMD

Provider Business Mailing Address
First Line	:	5005 OLD FEDERAL RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-1200
Country	:	US
Telephone Number	:	502-572-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2760 JEFFERSON CENTRE WAY STE 2
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-8266
Country	:	US
Telephone Number	:	812-284-2206
Fax Number	:	812-284-2216

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	01/14/2021

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