Healthcare Provider Details
I. General information
NPI: 1295729549
Provider Name (Legal Business Name): KAREN M REPINE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/01/2005
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 W MINERAL AVE STE 100
LITTLETON CO
80120-5612
US
IV. Provider business mailing address
1501 W MINERAL AVE STE 100
LITTLETON CO
80120-5612
US
V. Phone/Fax
- Phone: 303-730-0404
- Fax: 303-730-6163
- Phone: 303-730-0404
- Fax: 303-730-6163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 30803 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: