Most Relevant Information
Provider Data
| NPI Number: | 1003311036 |
| Provider Name: | LESLIE PEMBERTON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | TP698 |
Most Important Dates
| Enumeration Date: | 03/30/2018 |
| Last Updated: | 03/03/2022 |
Provider Practice Location
1921 LEITCHFIELD RD
OWENSBORO
KY
423031404
Practice Location Phone/Fax
| Phone: | 2704785334 |
| Fax: | 2702166920 |
Provider Mailing Location
PO BOX 3276
EVANSVILLE
IN
477313276
Provider Mailing Phone/Fax
| Phone: | 8124730181 |
| Fax: | 8124735822 |