Provider Demographics
NPI:1811041122
Name:SCHIPPER, LESLIE A (DO)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:SCHIPPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-716-8013
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:200 W COUNTY LINE RD
Practice Address - Street 2:STE 130
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2360
Practice Address - Country:US
Practice Address - Phone:303-791-0418
Practice Address - Fax:303-791-1849
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV2286207Q00000X
CO37386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0038573000OtherMEDICAID GROUP LAB NUMBER
WV1679672505OtherGROUP NPI
WV0010197000OtherMEDICAID GROUP NUMBER
WV9272492OtherMEDICARE P10
WV9272498OtherMEDICARE P10
WV9272498OtherMEDICARE P10