Provider Demographics
NPI:1922012772
Name:LESLIE, CHRISTOPHER JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:LESLIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BRYAN DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2158
Mailing Address - Country:US
Mailing Address - Phone:580-931-2278
Mailing Address - Fax:580-931-2274
Practice Address - Street 1:1400 BRYAN DR STE 300
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2158
Practice Address - Country:US
Practice Address - Phone:580-931-2278
Practice Address - Fax:580-931-2274
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORP344207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200744390AMedicaid
MO243026325Medicaid