Provider Demographics
NPI:1710023908
Name:UNDERWOOD, LESLIE E (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:E
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:FARRELL
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:325 MAINE STREET
Mailing Address - Street 2:MSO LIBRARY
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1335
Mailing Address - Country:US
Mailing Address - Phone:785-505-2988
Mailing Address - Fax:785-505-5228
Practice Address - Street 1:330 ARKANSAS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1335
Practice Address - Country:US
Practice Address - Phone:785-505-4950
Practice Address - Fax:785-505-5240
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6736207V00000X
MO2006015669207V00000X
KS0436905207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology