Provider Demographics
NPI:1891132833
Name:THOMAS, LESLIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:THOMAS
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 986
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-0986
Mailing Address - Country:US
Mailing Address - Phone:919-690-3000
Mailing Address - Fax:919-690-3000
Practice Address - Street 1:110 PROFESSIONAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565
Practice Address - Country:US
Practice Address - Phone:919-693-6541
Practice Address - Fax:919-693-7396
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00778207R00000X, 208000000X
NC191431390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program