Provider Demographics
NPI:1285699298
Name:ADCOCK, LESLIE H (NP)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:H
Last Name:ADCOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 COLLIER ROAD, NW
Mailing Address - Street 2:SUITE 5015
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1721
Mailing Address - Country:US
Mailing Address - Phone:404-605-5699
Mailing Address - Fax:404-355-4235
Practice Address - Street 1:95 COLLIER ROAD, NW
Practice Address - Street 2:SUITE 5015
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1721
Practice Address - Country:US
Practice Address - Phone:404-605-5699
Practice Address - Fax:404-355-4235
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN063419NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000868744GMedicaid
GAP06574Medicare UPIN
GA202I506300Medicare PIN