Provider Demographics
NPI:1831247378
Name:PAULUS, LESLIE KAY (MD, PHD, FACP)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:KAY
Last Name:PAULUS
Suffix:
Gender:F
Credentials:MD, PHD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E TUCKEY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1048
Mailing Address - Country:US
Mailing Address - Phone:602-377-3613
Mailing Address - Fax:602-285-9549
Practice Address - Street 1:3141 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4351
Practice Address - Country:US
Practice Address - Phone:602-749-5961
Practice Address - Fax:602-331-5155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine