Provider Demographics
NPI:1811940067
Name:LEPPARD, KATHARINE JULIA (MD)
Entity type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:JULIA
Last Name:LEPPARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:J
Other - Last Name:LEPPARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3470 CENTENNIAL BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4087
Mailing Address - Country:US
Mailing Address - Phone:719-575-1800
Mailing Address - Fax:719-575-1850
Practice Address - Street 1:3470 CENTENNIAL BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4087
Practice Address - Country:US
Practice Address - Phone:719-575-1800
Practice Address - Fax:719-575-1850
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC811877Medicare PIN