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Individual

MR. DAVID RODGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1650 COCHRANE CIR UNIT MEDDAC, FORT CARSON, CO 80913-4604
(719) 524-6517
Mailing address
1650 COCHRANE CIR UNIT MEDDAC, FORT CARSON, CO 80913-4604
(719) 524-6517

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LP60080597
WA
171000000X
Military Health Care Provider
1145181
363A00000X
Physician Assistant
Primary
PA60815222
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2121865
WA
Enumeration date
09/03/2014
Last updated
03/18/2025
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