Provider Demographics
NPI:1003896184
Name:TEMPEL, LAUREN KINGERY
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:KINGERY
Last Name:TEMPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 SOUTH PERRY STREET
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104
Mailing Address - Country:US
Mailing Address - Phone:303-688-3434
Mailing Address - Fax:303-688-4454
Practice Address - Street 1:1175 SOUTH PERRY STREET
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104
Practice Address - Country:US
Practice Address - Phone:303-688-3434
Practice Address - Fax:303-688-4454
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42365207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COI43348Medicare UPIN
CO803281Medicare ID - Type UnspecifiedMEDICARE NUMBER