Healthcare Provider Details

I. General information

NPI: 1972701019
Provider Name (Legal Business Name): LESLIE A MICHAUD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 W 119TH ST SUITE 250
OVERLAND PARK KS
66209-3724
US

IV. Provider business mailing address

5525 W 119TH ST STE 250
OVERLAND PARK KS
66209-3724
US

V. Phone/Fax

Practice location:
  • Phone: 913-808-5275
  • Fax:
Mailing address:
  • Phone: 913-808-5275
  • Fax: 913-257-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number04-36559
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: