Provider Demographics
NPI:1760453153
Name:MOATS, LESLIE MCARTHUR (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:MCARTHUR
Last Name:MOATS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:M
Other - Last Name:MOATS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 173891
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3891
Mailing Address - Country:US
Mailing Address - Phone:877-346-2211
Mailing Address - Fax:
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0048547207P00000X
CO48547207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98536745Medicaid
SC194239Medicaid
G77464Medicare UPIN
SCG774647914Medicare ID - Type Unspecified
COCO307375Medicare PIN