Leopold, Derek G
Leopold, Derek G is an individual health care provider with primary practice located at 1925 Mountain View Ave , Longmont CO 80501-3128. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Leopold, Derek G can be contacted via phone (303) 776-1234.Contact Information
Primary practice address
1925 Mountain View Ave
Longmont CO 80501-3128
Phone: (303) 776-1234
Fax: (720) 494-3107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | TL-3704 | Colorado |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | TL.0003704 | Colorado |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | DR.0055469 | Colorado |
Profile Details
| NPI number | 1255645214 |
|---|---|
| LBN Legal business name | Leopold, Derek G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2010 |
| Last updated | Sep 4th, 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 | 1255645214 | NPPES |
| Colorado | MEDICAID | 16323017 |
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