Provider Demographics
NPI:1215054556
Name:ASBURY, LESLIE ANN (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:ASBURY
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 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:615-920-7906
Mailing Address - Fax:615-920-8775
Practice Address - Street 1:360 AMSDEN AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1851
Practice Address - Country:US
Practice Address - Phone:859-340-1377
Practice Address - Fax:859-987-1107
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45189207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100136870Medicaid
KY45189OtherLICENSE
KYK057142Medicare PIN