MEDICARE: LEAH KELLY OZDEMIR D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	55286	CO
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	DR.0055286	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285938399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH KELLY OZDEMIR D.O.

Provider Business Mailing Address
First Line	:	640 PLAZA DR STE 105
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2399
Country	:	US
Telephone Number	:	303-996-2800
Fax Number	:	303-470-9595

Provider Business Practice Location Address
First Line	:	640 PLAZA DR STE 105
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2399
Country	:	US
Telephone Number	:	303-996-2800
Fax Number	:	303-470-9595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2011
Last Update Date	:	04/08/2024

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Directions to “ LEAH KELLY OZDEMIR D.O.” Practice Location

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