Healthcare Provider Details

I. General information

NPI: 1821294489
Provider Name (Legal Business Name): LESLIE ANNE FIELDS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SW LONGVIEW BLVD STE 200
LEES SUMMIT MO
64081-2116
US

IV. Provider business mailing address

400 SW LONGVIEW BLVD STE 200
LEES SUMMIT MO
64081-2116
US

V. Phone/Fax

Practice location:
  • Phone: 913-215-5008
  • Fax: 913-297-1202
Mailing address:
  • Phone: 816-502-8752
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2010017182
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2010017182
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: