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General NPI Number Information
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NPI Number | 1194780254
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Entity Type | Individual
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Provider Name | LESLIE C. HURT M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 94-1480 MOANIANI ST
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City | WAIPAHU
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State | HI
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Zip | 96797-4632
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Country | US
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Telephone | 808-432-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 700 LILLY RD NE
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City | OLYMPIA
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State | WA
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Zip | 98506-5196
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Country | US
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Telephone | 360-923-7000
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Fax | 360-923-7089
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101239722
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD-18723
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD61497880
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License Number State | WA
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