Leslie Clinic Inc.
Organization Active NPI Clinic/Center · Vici, OK
NPI 1447490453 · NPPES record last updated Mar 3, 2009
Key facts
- NPI
- 1447490453
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 10616 (OK)
- Legal business name
- LESLIE CLINIC INC.
- Practice address
- RR 1 Box A1
Vici, OK 73859-9106 - Phone
- (580) 995-3200
- Fax
- (580) 995-3202
- NPI assigned
- Mar 3, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Porter Bass Leslie, M.D.
- Title
- Medical Doctor/Practice Owner
- Phone
- (580) 995-3200
National Provider Directory
Locations
212 E Broadway
Vici, OK 73859
Phone (580) 995-3200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 10616 | OK | Yes |
Addresses
Primary practice location
RR 1 Box A1
Vici, OK 73859-9106
Mailing address
PO Box 45
Vici, OK 73859-0045
Phone (580) 995-3200
Other providers in Vici, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.