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NPI Code Detail

MEDICARE: LESLIE YVETTE DORSEY MD

MEDICARE: LESLIE YVETTE DORSEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician55122GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255388195
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE YVETTE DORSEY MD
Provider Business Mailing Address
First Line : PO BOX 278
Second Line :
City : JONESBORO
State : GA
Zip : 30237-0278
Country : US
Telephone Number : 770-968-9978
Fax Number : 770-968-9975
Provider Business Practice Location Address
First Line : 6645 LAKE DR
Second Line :
City : MORROW
State : GA
Zip : 30260-2354
Country : US
Telephone Number : 770-968-9978
Fax Number : 770-968-9975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 03/19/2010

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