Provider Demographics
NPI:1740206515
Name:CASHWELL, LEIGH ANN (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:CASHWELL
Suffix:
Gender:F
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:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452-0628
Mailing Address - Country:US
Mailing Address - Phone:601-947-9126
Mailing Address - Fax:901-947-1331
Practice Address - Street 1:859 WINTER ST
Practice Address - Street 2:
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-6603
Practice Address - Country:US
Practice Address - Phone:601-947-9126
Practice Address - Fax:601-947-1331
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS196222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS512I300167OtherMEDICARE PTAN
MS06173013Medicaid
MSI59459Medicare UPIN