Provider Demographics
NPI:1801092424
Name:CARNAHAN, LESLIE GAIL (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:GAIL
Last Name:CARNAHAN
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 1:23186 ARCADIA FARM RD
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-6019
Mailing Address - Country:US
Mailing Address - Phone:282-166-4502
Mailing Address - Fax:
Practice Address - Street 1:40 BURTON HILLS BLVD BLDG SUITE140
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6199
Practice Address - Country:US
Practice Address - Phone:615-673-4455
Practice Address - Fax:615-432-4651
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ81273207R00000X, 208000000X
GA90494207R00000X
AL43267207R00000X
TN64659207R00000X
LA329069207R00000X
MS23606207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics