Healthcare Provider Details

I. General information

NPI: 1518546407
Provider Name (Legal Business Name): LESLIE SWAFFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LESLIE STROUD MD

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N 12TH ST FL 2
PHOENIX AZ
85006-2837
US

IV. Provider business mailing address

2323 E HIGHLAND AVE UNIT 1518
PHOENIX AZ
85016-5220
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-5969
  • Fax: 602-521-5987
Mailing address:
  • Phone: 903-746-5153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number257633
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: