Provider Demographics
NPI:1821062340
Name:ROLFSON, BRIAN KEOLA (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:KEOLA
Last Name:ROLFSON
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:PO BOX 5788
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5788
Mailing Address - Country:US
Mailing Address - Phone:303-909-9859
Mailing Address - Fax:303-202-1281
Practice Address - Street 1:2551 W 84TH AVE
Practice Address - Street 2:ST. ANTHONY NORTH HOSPITAL, EMERGENCY DEPT.
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3807
Practice Address - Country:US
Practice Address - Phone:303-426-2020
Practice Address - Fax:303-426-2164
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32225207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTZ3280Medicaid
KS200384310AMedicaid
CO01322254Medicaid
WY113258000Medicaid
AZ448028Medicaid
NMS2048Medicaid
AZ448028Medicaid
COC803481Medicare PIN