Provider Demographics
NPI:1700090420
Name:JAGGERS, LESLIE DOTSON (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:DOTSON
Last Name:JAGGERS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 MILLWOOD TRAIL
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:678-556-9573
Mailing Address - Fax:404-351-9851
Practice Address - Street 1:1968 PEACHTREE RD
Practice Address - Street 2:PIEDMONT HOSPITAL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-605-2138
Practice Address - Fax:404-351-8951
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist