Provider Demographics
NPI:1639406325
Name:MASTERS, LESLIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:MASTERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8172 S LEWIS AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-1248
Mailing Address - Country:US
Mailing Address - Phone:918-296-7546
Mailing Address - Fax:918-296-7550
Practice Address - Street 1:8172 S LEWIS AVE STE D
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-1248
Practice Address - Country:US
Practice Address - Phone:918-296-7546
Practice Address - Fax:918-296-7550
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK21537207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine