Provider Demographics
NPI:1720014939
Name:ENGLAND, LESLIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:E
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 JEFFERSON DAVIS BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5140
Mailing Address - Country:US
Mailing Address - Phone:601-442-9802
Mailing Address - Fax:601-442-5802
Practice Address - Street 1:151 JEFFERSON DAVIS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5140
Practice Address - Country:US
Practice Address - Phone:601-442-9802
Practice Address - Fax:601-442-5802
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS8503174400000X
MS08503207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1190446Medicaid
MS640616881OtherALL BLUE CROSS
MS00017028Medicaid
64-0616881OtherTAX ID
LA1190446Medicaid
MSB64654Medicare UPIN
MS110229334Medicare ID - Type UnspecifiedRR MCARE/PALMETTO GBA
MS00017028Medicaid
MS640616881OtherALL BLUE CROSS