Provider Demographics
NPI:1962426916
Name:FOSS KING, LESLEY (RPH)
Entity type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:
Last Name:FOSS KING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2172 HARDY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:NC
Mailing Address - Zip Code:28551-8260
Mailing Address - Country:US
Mailing Address - Phone:252-566-5655
Mailing Address - Fax:
Practice Address - Street 1:306 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4932
Practice Address - Country:US
Practice Address - Phone:252-527-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13942183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist