Healthcare Provider Details

I. General information

NPI: 1215054556
Provider Name (Legal Business Name): LESLIE ANN ASBURY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 AMSDEN AVE SUITE 305
VERSAILLES KY
40383-1851
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-5098
US

V. Phone/Fax

Practice location:
  • Phone: 859-340-1377
  • Fax: 859-987-1107
Mailing address:
  • Phone: 615-920-7906
  • Fax: 615-920-8775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number45189
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: