Healthcare Provider Details

I. General information

NPI: 1396249231
Provider Name (Legal Business Name): LESLIE MCHALE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 BYPASS RD BLDG A
PIKEVILLE KY
41501-1602
US

IV. Provider business mailing address

900 S LIMESTONE CTW 304
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 606-430-3500
  • Fax:
Mailing address:
  • Phone: 859-323-9918
  • Fax: 859-323-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55209
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: