Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 01072928A | IN |
NPI | 1447491477 |
---|---|
Provider Name | Leslie Anne Foxlow |
First Address | Indianapolis, IN 46237-8600 |
Second Address | Indianapolis, IN 46237-8633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2009 |
Last Update Date | 07/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100047770 | (05) | IN |