Provider Demographics
NPI:1013902790
Name:LEIMBACH, GEORGE A (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:LEIMBACH
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 1:10963 MEADE WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2129
Mailing Address - Country:US
Mailing Address - Phone:303-438-1870
Mailing Address - Fax:
Practice Address - Street 1:9025 GRANT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4378
Practice Address - Country:US
Practice Address - Phone:303-657-9117
Practice Address - Fax:303-657-9015
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32197208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF43218Medicare UPIN