MEDICARE: DR. LEROY A. POPOWSKI O.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	152W00000X	Optometrist	2496	CO

General Provider Information

NPI Number	:	1881673978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEROY A. POPOWSKI O.D.

Provider Business Mailing Address
First Line	:	3470 CENTENNIAL BLVD
Second Line	:	SUITE 105
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4090
Country	:	US
Telephone Number	:	719-471-1107
Fax Number	:

Provider Business Practice Location Address
First Line	:	3470 CENTENNIAL BLVD
Second Line	:	SUITE 105
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4090
Country	:	US
Telephone Number	:	719-471-1107
Fax Number	:

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	08/06/2010

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