Provider Demographics
NPI:1881803203
Name:SMITH, LESLIE GENE (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:GENE
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:700 S SCHILLER ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-4735
Mailing Address - Country:US
Mailing Address - Phone:501-660-6644
Mailing Address - Fax:501-603-9497
Practice Address - Street 1:700 S SCHILLER ST STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-4735
Practice Address - Country:US
Practice Address - Phone:501-660-6644
Practice Address - Fax:501-603-9497
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC-79722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE89735Medicare UPIN