Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 37000 | CO |
NPI | 1063494367 |
---|---|
Provider Name | Dr. Michael Alan Rocklin |
First Address | Lone Tree, CO 80124-5532 |
Second Address | Lone Tree, CO 80124-5531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 14/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1N0240 | MEDICARE PTAN - ROCKY MOUNTAIN KIDNEY CARE AFFILIATION (01) | CO |
67524249 | (05) | CO |
CR6878 | MEDICARE PTAN (01) | CO |
H09739 | (02) | CO |
P02610126 | RAILROAD MEDICARE - ROCKY MOUNTAIN KIDNEY CARE LLC (01) | CO |