Individual
STEPHEN DALE LEATHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 S POTOMAC ST, AURORA, CO 80012-5411
(303) 695-2628
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2003-01485
NC
207P00000X
Emergency Medicine Physician
29303
SC
207P00000X
Emergency Medicine Physician
Primary
DR0050115
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32300051
—
CO
01
—
P01394181
RAILROAD MEDICARE
CO
Enumeration date
07/18/2006
Last updated
05/11/2015
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