MEDICARE: LESLIE ANN SCOTT M.D.,L.L.C.

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	174400000X	Specialist	2008018558	MO

General Provider Information

NPI Number	:	1821237827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESLIE ANN SCOTT M.D.,L.L.C.

Provider Business Mailing Address
First Line	:	10135 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-2103
Country	:	US
Telephone Number	:	314-521-1444
Fax Number	:	314-521-2299

Provider Business Practice Location Address
First Line	:	10135 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-2103
Country	:	US
Telephone Number	:	314-521-1444
Fax Number	:	314-521-2299

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LESLIE ANN SCOTT
Credential	:	M.D.
Telephone Number	:	314-521-1444

Provider Enumeration Date	:	02/13/2009
Last Update Date	:	02/13/2009

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