Provider Demographics
NPI:1659715159
Name:WINGET, LESLIE EUGENE III
Entity type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:EUGENE
Last Name:WINGET
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-3516
Mailing Address - Country:US
Mailing Address - Phone:262-577-3400
Mailing Address - Fax:
Practice Address - Street 1:7214 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-3516
Practice Address - Country:US
Practice Address - Phone:262-577-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3021237700000X
WI2107-60237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist