Provider Demographics
NPI:1831152156
Name:LESLIE, TODD A (DO)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
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 1:1450 MANOR HILL RD
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6643
Mailing Address - Country:US
Mailing Address - Phone:419-423-4994
Mailing Address - Fax:419-423-3326
Practice Address - Street 1:1450 MANOR HILL RD
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6643
Practice Address - Country:US
Practice Address - Phone:419-423-4994
Practice Address - Fax:419-423-3326
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0382929Medicaid
OHG13392Medicare UPIN
OH0382929Medicaid