Provider Demographics
NPI:1043856685
Name:LEPAGE, SCOTT MARCEL (PA-C)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:MARCEL
Last Name:LEPAGE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 LUTHERAN PKWY STE 360
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6032
Mailing Address - Country:US
Mailing Address - Phone:303-431-5280
Mailing Address - Fax:303-422-2002
Practice Address - Street 1:3555 LUTHERAN PKWY STE 360
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6032
Practice Address - Country:US
Practice Address - Phone:303-431-5280
Practice Address - Fax:303-422-2002
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006047363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant