Basic Information
Provider Information
NPI: 1528042033
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEEK
FirstName: JAMES
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 429
Address2:  
City: SALIDA
State: CO
PostalCode: 812010429
CountryCode: US
TelephoneNumber: 7195302000
FaxNumber: 7195302031
Practice Location
Address1: 550 W HWY 50
Address2:  
City: SALIDA
State: CO
PostalCode: 812012238
CountryCode: US
TelephoneNumber: 7195302000
FaxNumber: 7195302031
Other Information
ProviderEnumerationDate: 11/30/2005
LastUpdateDate: 04/29/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X37777-020WIN Allopathic & Osteopathic PhysiciansAnesthesiology 
208VP0014X37777-20WIY Allopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine

No ID Information.


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