Healthcare Provider Details

I. General information

NPI: 1235336520
Provider Name (Legal Business Name): CHRISTOPHER ROBERT RODRIGUEZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR EACH, BLDG 7500
FT CARSON CO
80913-4613
US

IV. Provider business mailing address

1650 COCHRANE CIR EACH, BLDG 7500
FT CARSON CO
80913-4613
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-7612
  • Fax:
Mailing address:
  • Phone: 719-526-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number02003199A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberDR.0066901
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDR.0066901
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: