Provider Demographics
NPI:1629072525
Name:NEWMAN, LESLIE JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:JOHN
Last Name:NEWMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:1370 GATEWAY BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2589
Practice Address - Country:US
Practice Address - Phone:615-895-6500
Practice Address - Fax:615-895-1741
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN024542207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF64632Medicare UPIN
TN3074941Medicare PIN