Provider Demographics
NPI:1952411225
Name:RICKMAN, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:RICKMAN
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 1:2351 G RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-9641
Mailing Address - Country:US
Mailing Address - Phone:802-334-3504
Mailing Address - Fax:802-334-3512
Practice Address - Street 1:41 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9835
Practice Address - Country:US
Practice Address - Phone:802-334-3504
Practice Address - Fax:802-334-3512
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138300208M00000X
CODR.0036616208M00000X
VT0420009448207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTMVPOther324005
VT00029500OtherBLUE SHIELD
VT0VN159Medicaid
VTVN1599Medicare ID - Type Unspecified
VT0VN159Medicaid