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General NPI Number Information
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NPI Number | 1881623379
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Entity Type | Individual
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Provider Name | LESLIE GREENSPAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 707 S MILLS ST
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City | MADISON
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State | WI
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Zip | 53715-1849
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Country | US
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Telephone | 608-258-6698
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Fax |
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Provider Business Mailing Address
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Address Line | S64W19011 SCHOOL DR
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City | MUSKEGO
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State | WI
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Zip | 53150-8516
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Country | US
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Telephone | 608-258-6699
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Fax | 608-259-5317
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 32303
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License Number State | WI
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