Healthcare Provider Details

I. General information

NPI: 1912944612
Provider Name (Legal Business Name): LESLIE E STRICKLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LEROY ST
POTSDAM NY
13676
US

IV. Provider business mailing address

50 LEROY ST
POTSDAM NY
13676-1799
US

V. Phone/Fax

Practice location:
  • Phone: 719-302-0034
  • Fax:
Mailing address:
  • Phone: 719-302-0034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number295077-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD29322
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: