Provider Demographics
NPI:1699738591
Name:FRINKS, LESLIE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ELIZABETH
Last Name:FRINKS
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:PO BOX 742167
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2167
Mailing Address - Country:US
Mailing Address - Phone:803-434-4300
Mailing Address - Fax:803-434-4251
Practice Address - Street 1:3555 HARDEN STREET EXT
Practice Address - Street 2:15 MEDICAL PARK RD, SUITE 141
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6894
Practice Address - Country:US
Practice Address - Phone:803-434-4300
Practice Address - Fax:803-434-4277
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC261219Medicaid
SCAA11134411Medicare PIN
SCSC52435771Medicare PIN
SCI42548Medicare UPIN
SCAA11135771Medicare PIN