Provider Demographics
NPI:1356608723
Name:SIZEMORE, LESLIE BIRDSONG (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:BIRDSONG
Last Name:SIZEMORE
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 1:1000 TOWNE CENTER BLVD BLDG 1200
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4129
Mailing Address - Country:US
Mailing Address - Phone:912-748-2280
Mailing Address - Fax:912-748-4988
Practice Address - Street 1:1000 TOWNE CENTER BLVD BLDG 1200
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4129
Practice Address - Country:US
Practice Address - Phone:912-748-2280
Practice Address - Fax:912-748-4988
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208096207Q00000X
GA080984207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine