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General NPI Number Information
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NPI Number | 1356410948
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Entity Type | Organization
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Legal Business Name | DAVID R. LESCH, M.D., LLC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 4385 JOHNS CREEK PARKWAY SUITE 230
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City | SUWANEE
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State | GA
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Zip | 30024-6095
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Country | US
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Telephone | 770-814-9455
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Fax | 678-990-5846
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Provider Business Mailing Address
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Address Line | 4385 JOHNS CREEK PARKWAY SUITE 230
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City | SUWANEE
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State | GA
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Zip | 30024-6095
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Country | US
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Telephone | 770-814-9455
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Fax | 678-990-5846
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | MR. DAVID R. LESCH
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Credential | M.D.
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Telephone | 770-814-9455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 031968
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License Number State | GA
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