Healthcare Provider Details

I. General information

NPI: 1043393044
Provider Name (Legal Business Name): CHRISTOPHER T RUSKEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E BOULDER ST
COLORADO SPRINGS CO
80909-5533
US

IV. Provider business mailing address

1901 N UNION BLVD STE 105
COLORADO SPRINGS CO
80909-7200
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-5000
  • Fax:
Mailing address:
  • Phone: 303-493-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number36458
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCO36458
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: