Individual
MR. KEITH O BODRERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6080 N CAREFREE CIR, COLORADO SPRINGS, CO 80922-2402
(719) 550-9100
(719) 380-0384
Mailing address
6080 N CAREFREE CIR, COLORADO SPRINGS, CO 80922-2402
(719) 550-9100
(719) 380-0384
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32687
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01326875
—
CO
Enumeration date
07/12/2005
Last updated
08/29/2013
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