Basic Information
| Provider Information | |||||||||
| NPI: | 1548290182 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEUPOLD | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ADRIAN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 1ST AVE E | ||||||||
| Address2: | STE C | ||||||||
| City: | SPENCER | ||||||||
| State: | IA | ||||||||
| PostalCode: | 513014342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122627511 | ||||||||
| FaxNumber: | 7126263658 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 HIGHWAY 71 SOUTH | ||||||||
| Address2: | |||||||||
| City: | SPIRIT LAKE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123361230 | ||||||||
| FaxNumber: | 7123368706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 06/20/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A88434 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 22158 | SC | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 36715 | IA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 48951 | MN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | AFE88434 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.