Provider Demographics
NPI:1063218410
Name:LESLIE, WESTY DAWN (PHARMD)
Entity type:Individual
Prefix:
First Name:WESTY
Middle Name:DAWN
Last Name:LESLIE
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HIGHWAY 89 S
Mailing Address - Street 2:
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9785
Mailing Address - Country:US
Mailing Address - Phone:501-350-4398
Mailing Address - Fax:
Practice Address - Street 1:3006 W 28TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-4803
Practice Address - Country:US
Practice Address - Phone:870-850-0159
Practice Address - Fax:870-850-0177
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08471183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist