Basic Information
| Provider Information | |||||||||
| NPI: | 1770979445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | APPLEGATE | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | RAE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HOXWORTH INTERNAL MEDICINE & PEDIATRICS CLINIC | ||||||||
| Address2: | 3130 HIGHLAND AVENUE 2ND FLOOR | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135847425 | ||||||||
| FaxNumber: | 5135847681 | ||||||||
| Practice Location | |||||||||
| Address1: | 234 GOODMAN ST | ||||||||
| Address2: | ML 665X | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135847425 | ||||||||
| FaxNumber: | 5135847681 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2015 | ||||||||
| LastUpdateDate: | 06/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 35.135137 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 35.135137 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.