Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | CO36458 | CO |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 36458 | CO |
NPI | 1043393044 |
---|---|
Provider Name | Dr. Christopher T Ruskey |
First Address | Colorado Springs, CO 80909-7200 |
Second Address | Colorado Springs, CO 80909-5533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 28/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01364587 | (05) | CO |
F72966 | (02) | CO |