Provider Demographics
NPI:1053684894
Name:HOHWEILER, LESLIE ALEX (RPH, DPH)
Entity Type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:ALEX
Last Name:HOHWEILER
Suffix:
Gender:M
Credentials:RPH, DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 TORREY PINES DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9288
Mailing Address - Country:US
Mailing Address - Phone:541-772-4836
Mailing Address - Fax:
Practice Address - Street 1:4750 TORREY PINES DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9288
Practice Address - Country:US
Practice Address - Phone:541-772-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9516183500000X
OR9811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist