Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | DR.0039667 | CO |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 39667 | CO |
NPI | 1447296025 |
---|---|
Provider Name | Dr. Robert Leland |
First Address | Superior, CO 80027-8661 |
Second Address | Boulder, CO 80301-3080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 05/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
77922239 | (05) | CO |