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General NPI Number Information
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NPI Number | 1215939541
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Entity Type | Individual
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Provider Name | TIMOTHY J RODGERS M. D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 5920 MCINTYRE ST
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City | GOLDEN
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State | CO
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Zip | 80403-7445
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Country | US
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Telephone | 303-949-1250
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Fax |
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Provider Business Mailing Address
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Address Line | 5920 MCINTYRE ST
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City | GOLDEN
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State | CO
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Zip | 80403-7445
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Country | US
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Telephone | 303-949-1250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 45729
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License Number State | CO
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