Individual
WILLIAM B REPERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1024 LEMAY AVE, FORT COLLINS, CO 80524-3929
(800) 553-4924
Mailing address
DEPT 2215, DENVER, CO 80291-0001
(800) 553-4924
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
21060
CO
207P00000X
Emergency Medicine Physician
Primary
21060
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01210608
—
CO
05
—
104344700
—
WY
01
—
930025633
RAILROAD MEDICARE
CO
Enumeration date
07/06/2006
Last updated
02/24/2011
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