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NPI Code Detail

MEDICARE: LEIGH T LILES M.D.

MEDICARE:   LEIGH T LILES  M.D.
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
12084P0800XPsychiatry Physician202265LA
22084P0804XChild & Adolescent Psychiatry Physician202265LA

General Provider Information

NPI Number : 1528269941
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEIGH T LILES M.D.
Provider Business Mailing Address
First Line : 1801 PARGOUD BLVD
Second Line :
City : MONROE
State : LA
Zip : 71201-2532
Country : US
Telephone Number : 318-470-5727
Fax Number :
Provider Business Practice Location Address
First Line : 2104 LOOP RD STE A
Second Line :
City : WINNSBORO
State : LA
Zip : 71295-3341
Country : US
Telephone Number : 318-435-6377
Fax Number : 318-435-6378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 05/01/2024

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Directions to “ LEIGH T LILES M.D.” Practice Location

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