MEDICARE: DAVID C LEPPLA M.D.

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	207T00000X	Neurological Surgery Physician	11236	NV

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
2	CC7599	OTHER	NV	BLUE CROSS BLUE SHIELD
3	880167036A023	OTHER	NV	TRICARE

General Provider Information

NPI Number	:	1477508018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C LEPPLA M.D.

Provider Business Mailing Address
First Line	:	5590 KIETZKE LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-3019
Country	:	US
Telephone Number	:	775-323-2080
Fax Number	:	775-325-2334

Provider Business Practice Location Address
First Line	:	5590 KIETZKE LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-3019
Country	:	US
Telephone Number	:	775-323-2080
Fax Number	:	775-325-2334

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	09/21/2016

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Directions to “ DAVID C LEPPLA M.D.” Practice Location

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