Individual
LESLIE PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1375 E 19TH AVE, DENVER, CO 80218-1114
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009-00842
NC
207R00000X
Internal Medicine Physician
Primary
48561
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020671
KAISER COMMERCIAL NUMBER
CO
05
—
02174260
—
CO
Enumeration date
04/17/2007
Last updated
06/04/2021
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