Healthcare Provider Details

I. General information

NPI: 1750739371
Provider Name (Legal Business Name): LEE REPLOGLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 S BROADWAY
LITTLETON CO
80122
US

IV. Provider business mailing address

628 S GROVE AVE
BARRINGTON IL
60010-4407
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8900
  • Fax:
Mailing address:
  • Phone: 224-305-4356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number267822
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number267822
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: