Provider Demographics
NPI:1609825967
Name:HANDLIN, LESLIE K (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:K
Last Name:HANDLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:K
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:300 PORTLAND ST STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7390
Mailing Address - Country:US
Mailing Address - Phone:573-886-4600
Mailing Address - Fax:573-886-4695
Practice Address - Street 1:300 PORTLAND ST STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7390
Practice Address - Country:US
Practice Address - Phone:573-886-4600
Practice Address - Fax:573-886-4695
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2H76207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202840914Medicaid
MO202840914Medicaid
P00474656Medicare PIN
220014552Medicare PIN
E82625Medicare UPIN
019010354Medicare PIN