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NPI Code Detail

MEDICARE: NICK LEPORA DO

MEDICARE:   NICK  LEPORA  DO
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
1207P00000XEmergency Medicine Physician03627KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111281846OTHERMICAQH
2000000829738OTHERKYBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851347819
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICK LEPORA DO
Provider Business Mailing Address
First Line : PO BOX 950112
Second Line : DEPT 52387
City : LOUISVILLE
State : KY
Zip : 40295-0112
Country : US
Telephone Number : 866-965-3774
Fax Number : 781-276-6411
Provider Business Practice Location Address
First Line : 913 N DIXIE AVE
Second Line : EMERGENCY DEPARTMENT
City : ELIZABETHTOWN
State : KY
Zip : 42701-2503
Country : US
Telephone Number : 877-783-6257
Fax Number : 859-514-5521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/19/2016

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