Edgcomb, Leslie Paul
Edgcomb, Leslie Paul is an individual health care provider with primary practice located at 5668 E State St , Rockford IL 61108-2464. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Edgcomb, Leslie Paul can be contacted via phone (815) 229-7580.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 036072104 | Illinois |
Profile Details
| NPI number | 1629014022 |
|---|---|
| LBN Legal business name | Edgcomb, Leslie Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Oct 6th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629014022 | NPPES |
| Illinois | MEDICAID | 036072104 | |
| Illinois | MEDICAID | 30696600 | |
| Illinois | Other | 020017328 |
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