MEDICARE: LEON D CHIPMAN 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	23591	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	:	1760488639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEON D CHIPMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1303
Second Line	:
City	:	FRISCO
State	:	CO
Zip	:	80443-1303
Country	:	US
Telephone Number	:	970-668-3633
Fax Number	:	970-668-4406

Provider Business Practice Location Address
First Line	:	0018 COUNTY ROAD 1030
Second Line	:	SUITE 125
City	:	FRISCO
State	:	CO
Zip	:	80443
Country	:	US
Telephone Number	:	970-668-3633
Fax Number	:	970-668-5052

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/08/2007

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Directions to “ LEON D CHIPMAN M.D.” Practice Location

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