Provider Demographics
NPI:1104034156
Name:HUDGINS, LESLEE EVANS (DO)
Entity Type:Individual
Prefix:
First Name:LESLEE
Middle Name:EVANS
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-390-8310
Mailing Address - Fax:843-390-8319
Practice Address - Street 1:3980 HIGHWAY 9 E
Practice Address - Street 2:SUITE 340
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-7832
Practice Address - Country:US
Practice Address - Phone:843-390-8310
Practice Address - Fax:843-390-8319
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology