Provider Demographics
NPI:1528094075
Name:CAMPOS, LEON P (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:P
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2417
Mailing Address - Fax:
Practice Address - Street 1:8890 N UNION BLVD STE 170
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-2701
Practice Address - Country:US
Practice Address - Phone:719-364-5005
Practice Address - Fax:719-365-9911
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2023-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME105086207Q00000X
IL036-090644207Q00000X
CODR.0071260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG05698Medicare UPIN