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General NPI Number Information
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NPI Number | 1467530618
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Entity Type | Individual
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Provider Name | LESLIE LEICHT M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1282 UNION AVE
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City | MEMPHIS
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State | TN
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Zip | 38104-3414
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Country | US
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Telephone | 989-657-1370
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Fax | 818-671-2225
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Provider Business Mailing Address
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Address Line | 8483 SILVERWIND DR
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City | MEMPHIS
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State | TN
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Zip | 38125-1730
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Country | US
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Telephone | 989-657-1370
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Fax | 901-821-0341
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | LL069193
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License Number State | MI
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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 | 48942
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 48942
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License Number State | TN
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