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General NPI Number Information
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NPI Number | 1700251436
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Entity Type | Organization
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Legal Business Name | LESLIE CAUDILL PLLC
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 204 23RD AVE N
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City | NASHVILLE
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State | TN
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Zip | 37203-1502
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Country | US
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Telephone | 615-321-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 9608 BOUCHAINE PASS
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City | BRENTWOOD
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State | TN
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Zip | 37027-3836
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Country | US
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Telephone | 270-776-2328
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Fax |
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Authorized Official
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Title or Position | MD
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Name | LESLIE CAUDILL
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Credential |
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Telephone | 270-776-2328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 49471
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License Number State | TN
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