MR. LESLIE P LIEGEL


Address: 8814 Timber Wolf Trl, Madison, WI 53717-2721
Phone: 6088278358

MR. LESLIE P LIEGEL (NPI# 1922084649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922084649
Entity Type Individual
Full Name MR. LESLIE P LIEGEL
Credential PAC
Practice Address 8814 Timber Wolf Trl
Madison
WI 53717-2721
Practice Telephone 6088278358
Enumeration Date 2005-12-15
Last Update Date 2020-06-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
819-23 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI PHYS PLUS PROV # 1009390 01
WI 42950700 05
WI RAILROAD MEDICARE PROV # P00144568 01
WI DEANCARE PROV # 70 01

Office Location

Street Address 8814 TIMBER WOLF TRL
City MADISON
State WI
Zip Code 53717-2721

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1740617430 Martha Darlene Kniffin Marriage & Family Therapist 1805 Excelsior Dr, The Family Center, Madison, WI 53717 2013-09-26
1740538305 Amber J Thompson Specialist 8202 Excelisor Dr, Madison, WI 53717 2012-08-29
1457622938 Kimberly F Lauth Physician Assistant 1200 Q Hammons Drive, Suite 400, Madison, WI 53717 2012-01-16
1699042499 Cameron K Birch Pharmacist 9741 Tree Lane, Suite 201, Madison, WI 53717 2011-11-22
1508023102 Katherine Jo Hartkopf Pharmacist 8501 Excelsior Drive, Rm. 337, Madison, WI 53717 2008-05-21
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962804211 Miranda Street Sudduth Physician Assistant 1607 Doctors Drive, Madison, MS 39110 2014-09-18
1184944068 Thomas Harvey Greene IIi Physician Assistant 248 Ne Hancock Ave, Madison, FL 32340-2560 2010-06-02
1699001735 Chad Jamison Gilliam Physician Assistant 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 2009-10-24
1679763700 Tamara A Melone Physician Assistant 2802 International Lane, Madison, WI 53708-0017 2007-07-25
1932237138 Craig Michael Roberts Physician Assistant 2631 Chamberlain Ave, Madison, WI 53705-3717 2007-03-01
1639234610 Sally-ann P Johannsen Physician Assistant 717 Hidden Cave Rd, Madison, WI 53717-2755 2006-12-27
1023105467 Nicole Anna Hanson Physician Assistant 1617 Sherman Avenue, Madison, WI 53708-0017 2006-10-06
1730137548 Renee A Knutson Physician Assistant 38 Hidden Hollow Trl, Madison, WI 53717-2501 2006-05-04
1669439329 Deanna J Nakada Physician Assistant 750 University Row, Madison, WI 53705-1311 2006-04-27
1326002213 Angela K Vitcenda Physician Assistant 701 Dane Street, Madison, WI 53713 2006-04-17
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Competitor

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City MADISON
Zip Code 53717

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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