Healthcare Provider Details

I. General information

NPI: 1740228568
Provider Name (Legal Business Name): LESLIE M SHARPE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 GRAVEL HILL RD
SOUTHAMPTON PA
18966-4003
US

IV. Provider business mailing address

696 GRAVEL HILL RD
SOUTHAMPTON PA
18966-4003
US

V. Phone/Fax

Practice location:
  • Phone: 215-357-4670
  • Fax: 215-357-4670
Mailing address:
  • Phone: 215-357-4670
  • Fax: 215-357-4670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD427697
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP9727
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036162667
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2449
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: