Provider Demographics
NPI:1700042132
Name:IMHOF, PRESTON LEIGH (DO)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:LEIGH
Last Name:IMHOF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4150 DEPUTY BILL CANTRELL MEMORIAL RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:770-292-3045
Mailing Address - Fax:770-292-3046
Practice Address - Street 1:4150 DEPUTY BILL CANTRELL MEMORIAL RD
Practice Address - Street 2:SUITE 260
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:770-292-3045
Practice Address - Fax:770-292-3046
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2025-04-09
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Provider Licenses
StateLicense IDTaxonomies
GA69331207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology