Individual
KYLE ROBERT CHRISTOPHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 270-2259
(970) 858-0798
Mailing address
PO BOX 4433, GRAND JUNCTION, CO 81502-4433
(970) 254-1686
(970) 254-1687
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
62042
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184036105
NPI
—
Enumeration date
05/26/2014
Last updated
08/21/2019
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