Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 47804 | MN |
N | 111NI0900X | Internist | 47804 | MN |
Y | 207RN0300X | Nephrologist | 43640 | AZ |
NPI | 1053386169 |
---|---|
Provider Name | Leslie Francis Thomas |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Phoenix, AZ 85054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I47044 | (02) |