Provider Demographics
NPI:1902496888
Name:MCWHERTER, LESLIE ROGERS (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ROGERS
Last Name:MCWHERTER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 ASPEN TRL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-6569
Mailing Address - Country:US
Mailing Address - Phone:423-280-1248
Mailing Address - Fax:
Practice Address - Street 1:3051 MAIN ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367-5745
Practice Address - Country:US
Practice Address - Phone:423-447-2134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist