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NPI Code Detail

MEDICARE: LESLEY A DOUGHTY M.D.

MEDICARE: LESLEY A DOUGHTY 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
12080P0203XPediatric Critical Care Medicine Physician35-08-5491OH

General Provider Information

NPI Number : 1538111273
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLEY A DOUGHTY M.D.
Provider Business Mailing Address
First Line : 3333 BURNET AVE
Second Line : ML 5021
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-4225
Fax Number : 513-636-2511
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line : ML 2005
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-636-4259
Fax Number : 513-636-4267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/08/2007

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