Provider Demographics
NPI:1275026643
Name:REPLOGLE, SCOTT LUTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LUTHER
Last Name:REPLOGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 MAJESTIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-4504
Mailing Address - Country:US
Mailing Address - Phone:303-666-4554
Mailing Address - Fax:
Practice Address - Street 1:1124 W DILLON RD STE 1
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1290
Practice Address - Country:US
Practice Address - Phone:720-485-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22528208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery