Organization
PIKES PEAK CENTER FOR COLON & RECTAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM G. RUDOLPH M.D. (OWNER)
(719) 635-0454
Entity
Organization
Contact information
Practice address
559 EAST PIKES PEAK AVE, SUITE #300, COLORADO SPRINGS, CO 80903
(719) 635-0454
(719) 473-3476
Mailing address
559 EAST PIKES PEAK AVE, SUITE #300, COLORADO SPRINGS, CO 80903
(719) 635-0454
(719) 473-3476
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
42378
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68302584
—
CO
Enumeration date
12/12/2006
Last updated
08/22/2020
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