Provider Demographics
NPI:1598760217
Name:RUMMEL, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:RUMMEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 E BOULDER ST
Mailing Address - Street 2:STE 204
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5756
Mailing Address - Country:US
Mailing Address - Phone:719-471-1069
Mailing Address - Fax:719-577-4828
Practice Address - Street 1:1725 E BOULDER ST
Practice Address - Street 2:SUITE 204
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5756
Practice Address - Country:US
Practice Address - Phone:719-471-1909
Practice Address - Fax:719-447-0425
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31557207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01315571Medicaid
COCOA109845Medicare PIN
CO01315571Medicaid
COA99024Medicare UPIN
COCC5464Medicare PIN