Individual
CHARLES R DYGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
56 CLUB MANOR DRIVE, SUITE 100, PUEBLO, CO 81008-1685
(719) 584-4767
(719) 595-7906
Mailing address
PO BOX 560825, DENVER, CO 80256-0825
(719) 595-7580
(719) 545-0176
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34483
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41571771
—
CO
Enumeration date
12/12/2006
Last updated
02/17/2016
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