Provider Demographics
NPI:1013178508
Name:CALCAGNO, CHRISTOPHER JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:CALCAGNO
Suffix:
Gender:M
Credentials:DO
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 560825
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80256-0825
Mailing Address - Country:US
Mailing Address - Phone:719-595-7580
Mailing Address - Fax:719-545-0176
Practice Address - Street 1:1600 N. GRAND AVE.
Practice Address - Street 2:STE. 300
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2742
Practice Address - Country:US
Practice Address - Phone:719-562-2001
Practice Address - Fax:719-562-2742
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015013207R00000X, 207RG0100X, 208D00000X
CODR.0062270207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000173652Medicaid