Provider Demographics
NPI:1285938399
Name:OZDEMIR, LEAH KELLY (DO)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:KELLY
Last Name:OZDEMIR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 PLAZA DR STE 105
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2399
Mailing Address - Country:US
Mailing Address - Phone:303-996-2800
Mailing Address - Fax:303-470-9595
Practice Address - Street 1:640 PLAZA DR STE 105
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2399
Practice Address - Country:US
Practice Address - Phone:303-996-2800
Practice Address - Fax:303-470-9595
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55286208M00000X
CODR.0055286207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53888804Medicaid
CO430928YWY1Medicare PIN