Provider Demographics
NPI:1992753032
Name:PAGE, LESLIE E F (DO)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:E F
Last Name:PAGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:315 N HILLSIDE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4915
Mailing Address - Country:US
Mailing Address - Phone:316-706-1788
Mailing Address - Fax:316-462-1214
Practice Address - Street 1:315 N HILLSIDE ST
Practice Address - Street 2:SUITE C
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4915
Practice Address - Country:US
Practice Address - Phone:316-706-1788
Practice Address - Fax:316-462-1214
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS05-20200207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1598825606Medicaid
E82511Medicare UPIN
E82511Medicare UPIN
NC2401167Medicare ID - Type Unspecified
NC89127NGMedicaid