Provider Demographics
NPI:1043226368
Name:LEIBLE, KARYN P (MD)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:P
Last Name:LEIBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 E LOWRY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7030
Mailing Address - Country:US
Mailing Address - Phone:303-912-7193
Mailing Address - Fax:
Practice Address - Street 1:1303 E 11TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-5051
Practice Address - Country:US
Practice Address - Phone:970-800-5402
Practice Address - Fax:970-669-6076
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264204207RG0300X
CODR.0031801207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01318013Medicaid
CO406780YLTTMedicare UPIN
COF41315Medicare UPIN
CO509768Medicare ID - Type Unspecified