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General NPI Number Information
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NPI Number | 1083673255
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Entity Type | Individual
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Provider Name | LESLYE HOWELL PACE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 2675 N DECATUR RD SUITE 506
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City | DECATUR
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State | GA
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Zip | 30033-6131
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Country | US
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Telephone | 404-299-1679
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Fax | 404-508-7558
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Provider Business Mailing Address
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Address Line | PO BOX 740209 DEPT. 1029
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City | ATLANTA
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State | GA
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Zip | 30374-0209
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Country | US
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Telephone | 941-360-1566
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Fax | 941-358-9818
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 057123
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License Number State | GA
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