Individual
DR. DEREK G LEOPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Mailing address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DR.0055469
CO
208600000X
Surgery Physician
TL.0003704
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL-3704
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16323017
—
CO
Enumeration date
08/02/2010
Last updated
09/04/2015
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