Provider Demographics
NPI:1598815888
Name:LAWRENCE, LESLIE E (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:E
Last Name:LAWRENCE
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:E
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6221 S CLAIBORNE AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4142
Mailing Address - Country:US
Mailing Address - Phone:504-402-6858
Mailing Address - Fax:504-323-2217
Practice Address - Street 1:6221 S CLAIBORNE AVE STE 209
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4142
Practice Address - Country:US
Practice Address - Phone:504-402-6858
Practice Address - Fax:504-323-2217
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15429R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1579815Medicaid
LA1579815Medicaid